Individual provider Active NPI

Kaye Aquinde Labasan, NP

  • Family Nurse Practitioner
  • San Mateo, CA
National Provider Identifier
1619756400
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023701 Issued in CA
Practice address
100 S Ellsworth Ave Ste 301
San Mateo, CA 94401-3931
Phone
(650) 342-0854
NPI assigned
Sep 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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 95023701 CA Primary

Addresses

Primary practice location

100 S Ellsworth Ave Ste 301
San Mateo, CA 94401-3931

Mailing address

1127 Sonata Dr
Vallejo, CA 94591-3874
Phone (707) 863-1000

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
I20240219001545 CA Practitioner - Nurse Practitioner 5395189336 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95023701CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Mateo Orthopedic Medical Group Inc CurrentSince Dec 20, 2023 Accepting new patients

Locations

100 S Ellsworth Ave
Ste 301
San Mateo, CA 94401
Phone (650) 342-0854

Interoperability endpoints

  • Direct secure messaging: klabasan675520@hisp.ehr.sutterhealth.org

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": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1619756400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 SONATA DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945913874",
            "telephone_number": "707-863-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE STE 301",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013931",
            "telephone_number": "650-342-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABASAN",
        "first_name": "KAYE",
        "middle_name": "AQUINDE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.