Individual provider Active NPI

Jill Adele Baron, NP

  • Family Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1497494058
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018911 Issued in CA
Practice address
200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone
(888) 562-5442
NPI assigned
Jun 1, 2022
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95018911 CA Primary

Addresses

Primary practice location

200 Oceangate Ste 100
Long Beach, CA 90802-4317

Mailing address

735 Island CT
San Diego, CA 92109-7707
Phone (724) 552-6243

Other names 1

  • Jill Adele Lantzy Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220623002138 CA Practitioner - Nurse Practitioner 6103205000 Reassigns benefits to 2 organizations
I20260108001133 WA Practitioner - Nurse Practitioner 6103205000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

200 Oceangate
Suite 100
Long Beach, CA 90802-4317

4304 Canterbury Dr
La Mesa, CA 91941-7801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95018911CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Care CurrentSince Sep 11, 2024 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Sep 11, 2024 Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince Dec 29, 2025 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

22522 29th Dr SE
#L210
Bothell, WA 98021
Phone (509) 774-7874

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

Interoperability endpoints

  • Direct secure messaging: jlantzy13521@direct-prd.molinahealthcare.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1497494058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 ISLAND CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921097707",
            "telephone_number": "724-552-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "888-562-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARON",
        "first_name": "JILL",
        "middle_name": "ADELE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95018911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "LANTZY",
            "middle_name": "ADELE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.