Elizabeth Pruett

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95030919 Issued in CA

Practice address

555 Washington St
San Diego, CA 92103-2289

Phone

(619) 260-8300

NPI assigned

Jul 30, 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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hom Medical Group IncGroup PAC ID 3870498694, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hom Medical Group Inc

  • Hospitalist Physician
  • La Jolla, CA
  • NPI 1366575169
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1659359446
  Care Compare affiliation

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1659100436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 NIAGARA AVE APT 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921076108",
            "telephone_number": "864-641-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WASHINGTON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032289",
            "telephone_number": "619-260-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUETT",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Provision Pharmacy, Inc. -LTC
• Melissa Provost
• Kayleigh Prowse, NP
• Proxima Medical Group
• Brigite Prud'Homme
• Michelle Pruett, NP
• Zhike Pruett, N.P.
• Yaron Pruginin, PSY.D.
• Bianca Lashea Pruitt
• Jacey Layne Pruitt

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, 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 Jul 30, 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.