Individual provider Active NPI

Joseph Lao De Jesus, FNP

  • Family Nurse Practitioner
  • Arvin, CA
National Provider Identifier
1558098566
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021868 Issued in CA
Practice address
146 N Hill St
Arvin, CA 93203-1014
Phone
(661) 855-4468
NPI assigned
Aug 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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 95021868 CA Primary

Addresses

Primary practice location

146 N Hill St
Arvin, CA 93203-1014

Mailing address

146 N Hill St
Arvin, CA 93203-1014
Phone (661) 855-4468

Other identifiers 1

IdentifierTypeStateIssuer
572618903MedicaidCA

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
I20221213000420 CA Practitioner - Nurse Practitioner 6901275007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica Sierra VistaGroup PAC ID 3870407505, 180 clinicians

Practice addresses (Care Compare)

1305 Bear Mountain Blvd
Arvin, CA 93203-1231
Phone (661) 854-3131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95021868CAMDFamily Nurse Practitioner

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Clinica Sierra Vista CurrentSince Jan 13, 2025 Accepting new patients
Clinica Sierra Vista Current Accepting new patients
Clinica Sierra Vista CurrentSince Jan 13, 2025 Accepting new patients

Locations

1305 Bear Mountain Blvd
Arvin, CA 93203
Phone (661) 854-3131

146 N Hill St
Arvin, CA 93203
Phone (661) 854-3131

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jlaodejesus20197@clinicasierravista.direct-ci.com

Organizations & group practices 3

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1558098566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 N HILL ST",
            "city": "ARVIN",
            "state": "CA",
            "postal_code": "932031014",
            "telephone_number": "661-855-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 N HILL ST",
            "city": "ARVIN",
            "state": "CA",
            "postal_code": "932031014",
            "telephone_number": "661-855-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "JOSEPH",
        "middle_name": "LAO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "572618903",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvin, CA

Sources for this page

Verify at the official NPI Registry.