Individual provider Active NPI

Jennifer Marina Muniz

  • Family Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1568005833
Registry record updated Oct 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95012989 Issued in CA
Practice address
1800 Western Ave Ste 305
San Bernardino, CA 92411-1354
Phone
(909) 880-9993
NPI assigned
Oct 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2019

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 95012989 CA Primary

Addresses

Primary practice location

1800 Western Ave Ste 305
San Bernardino, CA 92411-1354

Mailing address

8179 Branding Iron LN
Riverside, CA 92508-6613
Phone (626) 392-2191

Other practice location 1

8179 Branding Iron Ln
Riverside, CA 92508-6613
Phone (626) 392-2191

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
I20210915002183 CA Practitioner - Nurse Practitioner 2062818149 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Redlands Family Physicians Medical Associates, Inc. Current Accepting new patients
Alfaro-McField Medical Clinic Inc CurrentSince Oct 27, 2019 Accepting new patients
Redlands Family Practice Medical Group Inc. CurrentSince Sep 27, 2021 Accepting new patients

Locations

1520 Barton Rd
Redlands, CA 92373
Phone (909) 793-3208

1800 Western Ave
Ste 305
Sn Bernrdno, CA 92411
Phone (909) 747-8155

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": "1571443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571443200000",
    "number": "1568005833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8179 BRANDING IRON LN",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925086613",
            "telephone_number": "626-392-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESTERN AVE STE 305",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111354",
            "telephone_number": "909-880-9993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8179 Branding Iron Ln",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925086613",
            "country_code": "US",
            "telephone_number": "626-392-2191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNIZ",
        "first_name": "JENNIFER",
        "middle_name": "MARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-19",
        "last_updated": "2019-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.