Individual provider Active NPI

Andrea L Moushigian, NP

  • Nurse Practitioner
  • Clovis, CA
National Provider Identifier
1619906989
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15837 Issued in CA
Practice address
681 Medical Center Dr W
Suite 101
Clovis, CA 93611-6803
Phone
(559) 323-9300
NPI assigned
Jun 30, 2006
Last updated
Oct 31, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15837 CA Primary

Addresses

Primary practice location

681 Medical Center Dr W
Suite 101
Clovis, CA 93611-6803

Mailing address

9036 N Recreation Ave
Fresno, CA 93720-4139
Phone (559) 307-3152

Other identifiers 1

IdentifierTypeStateIssuer
243023MedicaidOR

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
I20080125000189 CA Practitioner - Nurse Practitioner 9032291331 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15837CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Central Calif ENT Medical Group CurrentSince Dec 4, 2023 Accepting new patients
Cep America - California CurrentSince Nov 1, 2007 Accepting new patients
Cep America-California CurrentSince Nov 1, 2007 Accepting new patients
Michael L Illingworth, MD Inc Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1351 E Spruce Ave
Fresno, CA 93720
Phone (559) 432-3303

1250 E Almond Ave
Madera, CA 93637
Phone (559) 675-5501

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1619906989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9036 N RECREATION AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204139",
            "telephone_number": "559-307-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 MEDICAL CENTER DR W",
            "address_2": "SUITE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116803",
            "telephone_number": "559-323-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSHIGIAN",
        "first_name": "ANDREA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "15837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243023",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.