Heather Sue Nenadovic, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95032079 Issued in CA

Practice address

7974 Haven Ave Ste 250
Rancho Cucamonga, CA 91730-3063

Phone

(800) 734-1733

Fax

(800) 734-1733

NPI assigned

Nov 18, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Southern California Keck School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gateway Medicor - Rancho Cucamonga IncGroup PAC ID 3476994666, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gateway Medicor - Rancho Cucamonga Inc.

  • Family Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1932974896
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1477378230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 ROCHELLE LN",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928828530",
            "telephone_number": "949-835-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE STE 250",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303063",
            "telephone_number": "800-734-1733",
            "fax_number": "800-734-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NENADOVIC",
        "first_name": "HEATHER",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "665933",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karlie Ann Nelson
• Michael Nelson, RASI
• Tyler Samone Nelson
• Brooke Lynn Nemo, RDN
• Dana Nemou, PA
• Deyanna Nettles
• Alonzo Esparza Nevarez, LEP
• New Beginnings Addiction & Recovery Center
• New Community Hospice & Palliative Care, Inc.
• New Hope Transport, LLC

• Family Nurse Practitioner in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.