Individual provider Active NPI

Daryl Gene Nanale Magada, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1487388492
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
71012804A Issued in IN
Practice address
7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160
Phone
(260) 435-7001
Fax
(260) 434-6456
NPI assigned
Jul 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 28243886A IN
Critical Care Medicine Nurse Practitioner 363LC0200X 71012804A IN
Acute Care Nurse Practitioner 363LA2100X 71012804A IN Primary

Addresses

Primary practice location

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4160

Mailing address

5001 Buell Dr
Fort Wayne, IN 46807-3205
Phone (714) 814-4832

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240515004161 CA Practitioner - Nurse Practitioner 7113301698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Specialists of California PCGroup PAC ID 3476864448, 373 clinicians

Practice addresses (Care Compare)

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 624-2001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.99 of 100Reported as apm
Quality
77.41
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71012804AINMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Specialists of California, PC CurrentSince Apr 1, 2024 Accepting new patients

Locations

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1487388492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 BUELL DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468073205",
            "telephone_number": "714-814-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044160",
            "telephone_number": "260-435-7001",
            "fax_number": "260-434-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGADA",
        "first_name": "DARYL GENE",
        "middle_name": "NANALE",
        "name_prefix": "Mrs.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IN",
            "license": "28243886A",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "IN",
            "license": "71012804A",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71012804A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.