Individual provider Active NPI

Jaquolin Eskandr, FNP

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1508219718
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
95004518 Issued in CA
Practice address
9041 Magnolia Ave
Riverside, CA 92503-3900
Phone
(951) 687-0004
NPI assigned
Jul 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 95004518 CA Primary

Addresses

Primary practice location

9041 Magnolia Ave
Riverside, CA 92503-3900

Mailing address

13741 Andele Way
Irvine, CA 92620-3228
Phone (714) 705-3195

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
I20200714000856 CA Practitioner - Nurse Practitioner 3971926627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Care Medical IncGroup PAC ID 7517385792, 2 clinicians

Practice addresses (Care Compare)

400 Newport Ctr Dr
Suite 301
Newport Beach, CA 92660-7604
Phone (949) 644-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95004518CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Medical Inc Single Specialty CurrentSince Oct 15, 2020 Accepting new patients
Lawrence Y Lo MD Inc Single Specialty CurrentSince Oct 15, 2020 Accepting new patients

Locations

400 Newport Center Dr
Ste 301
Newport Beach, CA 92660
Phone (949) 644-1300

Organizations & group practices 2

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": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1508219718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13741 ANDELE WAY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926203228",
            "telephone_number": "714-705-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033900",
            "telephone_number": "951-687-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESKANDR",
        "first_name": "JAQUOLIN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-22",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95004518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.