Individual provider Active NPI

Tori Rachel Kretschmer, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1578284600
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022396 Issued in CA
Practice address
1550 Superior Ave
Costa Mesa, CA 92627-3778
Phone
(949) 270-2100
Fax
(949) 650-4458
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 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 95022396 CA Primary

Addresses

Primary practice location

1550 Superior Ave
Costa Mesa, CA 92627-3778

Mailing address

20151 SW Birch Street, Suite 100
Newport Beach, CA 92660-1794
Phone (949) 270-2100

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
I20230104002896 CA Practitioner - Nurse Practitioner 7315317526 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Share Our Selves Corporation CurrentSince Oct 1, 2022 Accepting new patients
Share Our Selves Corporation CurrentSince Oct 1, 2022 Accepting new patients
Share Our Selves Corporation Current Accepting new patients
Share Our Selves Corporation Current Accepting new patients

Locations

1550 Superior Ave
Costa Mesa, CA 92627
Phone (949) 650-0186

20151 SW Birch St
Ste 100
Newport Beach, CA 92660

Interoperability endpoints

  • Direct secure messaging: tkretschmer599456@direct.ochin.org

Organizations & group practices 4

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1578284600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20151 SW BIRCH STREET, SUITE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601794",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 SUPERIOR AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273778",
            "telephone_number": "949-270-2100",
            "fax_number": "949-650-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETSCHMER",
        "first_name": "TORI",
        "middle_name": "RACHEL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.