Individual provider Active NPI

Stephanie Ayroso Madridejos, FNP-C, FNP-BC

  • Family Nurse Practitioner
  • Panorama City, CA
National Provider Identifier
1548085095
Registry record updated Feb 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95033918 Issued in CA
Practice address
8744 Cantaloupe Ave,
Panorama City, CA 91402
Phone
(818) 445-4204
NPI assigned
Nov 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 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 95033918 CA Primary

Addresses

Primary practice location

8744 Cantaloupe Ave,
Panorama City, CA 91402

Mailing address

31 Beacon Way
Aliso Viejo, CA 92656
Phone (949) 413-3811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 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
I20250320003504 CA Practitioner - Nurse Practitioner 1153843909 Reassigns benefits to 2 organizations
I20250422001306 NV Practitioner - Nurse Practitioner 1153843909 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Care Allianz Health Services LLC CurrentSince Feb 23, 2025 Accepting new patients
Molina Healthcare of California CurrentSince Apr 7, 2025 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Apr 7, 2025 Accepting new patients
Molina Care Connections, LLC. CurrentSince Apr 8, 2025 Accepting new patients

Locations

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

8329 W Sunset Rd
Ste 100
Las Vegas, NV 89113

Interoperability endpoints

  • Direct secure messaging: smadridejos18638@direct-prd.molinahealthcare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739577600000",
    "number": "1548085095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BEACON WAY",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "92656",
            "telephone_number": "949-413-3811",
            "fax_number": "949-317-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8744 CANTALOUPE AVE,",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "91402",
            "telephone_number": "818-445-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRIDEJOS",
        "first_name": "STEPHANIE",
        "middle_name": "AYROSO",
        "credential": "FNP-C, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2025-02-15",
        "certification_date": "2025-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95033918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

Verify at the official NPI Registry.