Pulmer Jack Pulido, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95025259 Issued in CA

Practice address

1360 E Anaheim St Ste 101
Long Beach, CA 90813-5515

Phone

(562) 270-0324

Fax

(562) 591-0109

NPI assigned

May 30, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Medical Wellness Centers USAGroup PAC ID 1759665367, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 Medical Wellness Centers USA

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1235500513
  Medicare reassignment Care Compare group NPD
• Community Medical Wellness Centers USA

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1689449571
  NPD

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1578256228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E ANAHEIM ST STE 101",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908135515",
            "telephone_number": "562-270-0324",
            "fax_number": "562-591-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 E ANAHEIM ST STE 101",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908135515",
            "telephone_number": "562-270-0324",
            "fax_number": "562-591-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULIDO",
        "first_name": "PULMER JACK",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cameron Pugrad
• Madeleine Francesca Puig, MD
• Jacqueline Janet Pujol, MD
• Maria Pulido Torrez
• Jazmin Pulido
• Pulmonary and Critical Care Consultants Inc
• Taylor Pulsifer, CMT
• Henry Pun
• Patrick Punzalan, COTA
• Tania Punzalan, FNP

• Psychiatric/Mental Health Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.