Wellah Marie Sombilla San Buenaventura

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95013309 Issued in CA

Practice address

1775 3Rd St
Atwater, CA 95301-3608

Phone

(209) 358-5611

NPI assigned

Nov 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 4

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Centers of AmericaGroup PAC ID 3476813460, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ameriprime Home Health Care Home health agency, Tracy, CA, CCN 757096
• Mercy Medical Center Hospital, Merced, CA, CCN 050444

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Mariposa, CA
  • NPI 1891207684
  Medicare reassignment Care Compare group NPD
• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Gustine, CA
  • NPI 1245105733
  NPD

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

• Ameriprime Healthcare Inc.

  • Home Health Agency
  • Tracy, CA
  • NPI 1356014450
  Care Compare affiliation
• Dignity Health

  • General Acute Care Hospital
  • Merced, CA
  • NPI 1518018191
  Care Compare affiliation

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1548806953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 ST TROPEZ CT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953489539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 3RD ST",
            "city": "ATWATER",
            "state": "CA",
            "postal_code": "953013608",
            "telephone_number": "209-358-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN BUENAVENTURA",
        "first_name": "WELLAH MARIE",
        "middle_name": "SOMBILLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95013309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wellah-sanbuenaventura@atwatermedical.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "1775 3rd St",
            "city": "Atwater",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953013608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wellah-sanbuenaventura@atwatermedical.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "1775 3rd St",
            "city": "Atwater",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953013608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wellah-sanbuenaventura@atwatermedical.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "1775 3rd St",
            "city": "Atwater",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953013608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wellah-sanbuenaventura@atwatermedical.e-mdsdirect.com",
            "affiliation": "N",
            "address_1": "1775 3rd St",
            "city": "Atwater",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953013608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Candy Salas
• Fernanda Isabel Salazar-Arriagada
• Jorge Salmeron Bernal, FNP
• Olive Saludez Magaipo
• Jonathan Samaniego
• Nanci Sanchez-Garcia
• Crystal Sanchez
• Cynthia Sanchez
• Eric J Sanchez
• Ernesto Sanchez

• Gerontology Nurse Practitioner in Atwater, CA
• Providers in Atwater, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.