Individual provider Active NPI

Kimberly Cuenca, NP

  • Family Nurse Practitioner
  • El Segundo, CA
National Provider Identifier
1568213270
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
234042 Issued in LA
Practice address
222 N Pacific Coast Hwy Ste 2175
El Segundo, CA 90245-5639
Phone
(877) 878-3289
NPI assigned
Mar 29, 2024
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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 234042 LA Primary

Addresses

Primary practice location

222 N Pacific Coast Hwy Ste 2175
El Segundo, CA 90245-5639

Mailing address

222 N Pacific Coast Hwy Ste 2175
El Segundo, CA 90245-5639
Phone (877) 878-3289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20240703000726 LA Practitioner - Nurse Practitioner 8628512456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Robert Marriott Medical CorpGroup PAC ID 2567531494, 63 clinicians

Practice addresses (Care Compare)

915 1St St
Winnfield, LA 71483-2945
Phone (877) 878-3289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234042LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Marriott Medical Corp CurrentSince May 20, 2024 Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 1420
El Segundo, CA 90245

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

7307 E Old Spanish Trl
Jeanerette, LA 70544
Phone (337) 276-4514

5301 Tullis Dr
New Orleans, LA 70131
Phone (337) 893-6140

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1568213270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 2175",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455639",
            "telephone_number": "877-878-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 2175",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455639",
            "telephone_number": "877-878-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUENCA",
        "first_name": "KIMBERLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "234042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.