Individual provider Active NPI

Jeanelle Maglanoc Ong, NP

  • Adult Health Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1598524498
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95027704 Issued in CA
Practice address
16100 Sand Canyon Ave Ste 240
Irvine, CA 92618-3724
Phone
(949) 636-1858
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95027704 CA
Adult Health Nurse Practitioner 363LA2200X 95027704 CA Primary

Addresses

Primary practice location

16100 Sand Canyon Ave Ste 240
Irvine, CA 92618-3724

Mailing address

18617 Klum PL
Rowland Heights, CA 91748-4854
Phone (626) 512-4713

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
I20241115000936 CA Practitioner - Nurse Practitioner 7416481254 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95027704CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geriheal PC CurrentSince Sep 5, 2024 Accepting new patients

Locations

9808 Venice Blvd
Ph
Culver City, CA 90232
Phone (310) 733-4171

9640 Venice Blvd
Culver City, CA 90232
Phone (310) 803-6013

Interoperability endpoints

  • Direct secure messaging: jeanelle.ong.1@25529.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25529/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1598524498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18617 KLUM PL",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917484854",
            "telephone_number": "626-512-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE STE 240",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183724",
            "telephone_number": "949-636-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG",
        "first_name": "JEANELLE",
        "middle_name": "MAGLANOC",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95027704",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95027704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.