Mara Jasmin Banuelos, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95029296 Issued in CA

Practice address

12296 Roswell Ave
Chino, CA 91710-2046

Phone

(626) 348-7920

NPI assigned

Apr 16, 2024

Sex

Female

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

Swapna V Phadnis MD IncGroup PAC ID 8022507904, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3574/brand/1/csg/1/fhir/r4

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.

• Swapna V Phadnis MD Inc

  • Family Medicine Physician
  • Glendora, CA
  • NPI 1609454297
  Medicare reassignment Care Compare group NPD
• Jun R. Chiong, MD, MPH, Inc.

  • Internal Medicine Physician
  • Redlands, CA
  • NPI 1093099046
  Medicare reassignment NPD
• Supportive Care Specialists

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1518705771
  Medicare reassignment NPD
• Medex Specialty Network, Inc.

  • Cardiovascular Disease Physician
  • Redlands, CA
  • NPI 1659134252
  NPD

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1619721578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12296 ROSWELL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102046",
            "telephone_number": "626-348-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12296 ROSWELL AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102046",
            "telephone_number": "626-348-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "MARA",
        "middle_name": "JASMIN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittny Ball, SLP
• Jessica Denise Baluyot
• Bam and Associates LLC Dba Comfort Keepers
• Kerim Bangou
• Nancy Banh, OD
• Sandra Banuelos
• Barbara Allen Legacy Foundation
• Carlene Barbosa
• Jacqueline Adriana Barbosa, PA-C
• Veronica Scheele Baron-Vartian, LCSW, PPSC

• Family Nurse Practitioner in Chino, CA
• Providers in Chino, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.