Organization Active NPI

Elite Aesthetics & Dermatology Inc

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1669177192
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ELITE AESTHETICS & DERMATOLOGY INC
Practice address
3409 Calloway Dr Unit 602
Bakersfield, CA 93312-2534
Phone
(661) 218-9923
NPI assigned
Apr 3, 2023
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Jennifer Tougas-Genova, FNP-C
Title
Nurse Practitioner
Phone
(413) 519-5594

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3409 Calloway Dr Unit 602
Bakersfield, CA 93312-2534

Mailing address

3409 Calloway Dr Unit 602
Bakersfield, CA 93312-2534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230821002817 CA Part B Supplier - Clinic/Group Practice 0547622649 Receives reassigned benefits from 5 practitioners
Practice locations: Bakersfield, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1669177192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 CALLOWAY DR UNIT 602",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 CALLOWAY DR UNIT 602",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933122534",
            "telephone_number": "661-218-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE AESTHETICS & DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "TOUGAS-GENOVA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "413-519-5594",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.