Individual provider Active NPI

Sarah Elizabeth Van Tassell, FNP

  • Family Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1619252152
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21366 Issued in CA
Practice address
25835 Barton Rd
Suite 101
Loma Linda, CA 92354-3897
Phone
(909) 558-3611
NPI assigned
Oct 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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 21366 CA Primary

Addresses

Primary practice location

25835 Barton Rd
Suite 101
Loma Linda, CA 92354-3897

Mailing address

217 N Dearborn St
Redlands, CA 92374-4282
Phone (909) 754-5707

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
I20240628000202 CA Order and Referring Only - Nurse Practitioner 5294901955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21366CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Office Inc a Professional Medical Corporation PastSince Sep 12, 2018 Accepting new patients
Neighborhood Healthcare PastSince Feb 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1318723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1619252152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N DEARBORN ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744282",
            "telephone_number": "909-754-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25835 BARTON RD",
            "address_2": "SUITE 101",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543897",
            "telephone_number": "909-558-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSELL",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-16",
        "last_updated": "2012-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.