Nicole Fernandes

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95012649 Issued in CA

Practice address

3850 Grand Ave
Oakland, CA 94610-1004

Phone

(888) 663-6331

Fax

(415) 252-7176

NPI assigned

Mar 21, 2020

Last updated

Oct 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Telehealth

Offers telehealth services

Group practices

One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.fernandes@49412312072196.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• One Medical Group, Inc.

  dba One Medical Group

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1467781641
  Medicare reassignment Care Compare group NPD
• Santa Rosa Community Health Centers

  dba Vista Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  dba Lombardi Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1386712065
  NPD
• Santa Rosa Community Health Centers

  dba Caritas Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD
• One Medical Group, Inc

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1891521134
  NPD

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

{
    "created_epoch": "1584748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1558997569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946101004",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-21",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95012649",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012649",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE NUMBER",
            "identifier": "95012649",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nwoye Ferguson
• Rollington Ferguson, MD
• Susan Callaway Ferguson, MD
• Wanda Gale Ferguson, RN, MSN
• Giselle Fernandes, MD
• Christine Fernandez, RN,PHN
• Diego Rafael Fernandez, M.D.
• Irene Fernandez
• Jess Fernandez
• Joseph Pearl Fernandez, RN

• Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.