Individual provider Active NPI

Sarah Elizabeth Tamayo-Perez, FNP-C

  • Family Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1548634744
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003182 Issued in CA
Practice address
16465 Sierra Lakes Pkwy
Suite 300
Fontana, CA 92336-1242
Phone
(909) 429-2864
NPI assigned
Nov 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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 95003182 CA Primary

Addresses

Primary practice location

16465 Sierra Lakes Pkwy
Suite 300
Fontana, CA 92336-1242

Mailing address

16465 Sierra Lakes Pkwy
Suite 300
Fontana, CA 92336-1242
Phone (909) 609-4199

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
I20230829001699 CA Practitioner - Nurse Practitioner 7517389943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cucamonga Valley Medical Group IncGroup PAC ID 6709899883, 24 clinicians

Practice addresses (Care Compare)

16839 Ramona Ave
Suite 401
Fontana, CA 92336-2014
Phone (909) 429-2864

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003182CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cucamonga Valley Medical Group, Inc. CurrentSince Jul 17, 2023 Accepting new patients

Locations

16839 Ramona Ave
Ste 401
Fontana, CA 92336
Phone (909) 429-2864

16465 Sierra Lakes Pkwy
Ste 300
Fontana, CA 92336
Phone (909) 429-2864

1310 San Bernardino Rd
Ste 105
Upland, CA 91786
Phone (909) 429-2864

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.

NPI Registry JSON

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

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1548634744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY",
            "address_2": "SUITE 300",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-609-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY",
            "address_2": "SUITE 300",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-429-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMAYO-PEREZ",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.