Individual provider Active NPI

Claudine Mae Ma, MSN NP

  • Nurse Practitioner
  • San Bernardino, CA
National Provider Identifier
1689281594
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95015113 Issued in CA
Practice address
3972 N Waterman Ave Ste 104
San Bernardino, CA 92404-1767
Phone
(909) 433-9700
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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 95015113 CA Primary

Addresses

Primary practice location

3972 N Waterman Ave Ste 104
San Bernardino, CA 92404-1767

Mailing address

25971 Reed Way
Loma Linda, CA 92354-3888
Phone (626) 731-1632

Other practice location 1

5562 Philadelphia St
Chino, CA 91710-2466
Phone (713) 589-5283

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
I20210907000569 CA Practitioner - Nurse Practitioner 7618373366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing Community Health CenterGroup PAC ID 1951711639, 4 clinicians

Practice addresses (Care Compare)

3972 N Waterman Ave
Suite 104
San Bernardino, CA 92404-1767
Phone (909) 433-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95015113CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Community Health Center CurrentSince May 5, 2021 Accepting new patients
Blessing Community Health Center PastSince May 5, 2021 Accepting new patients

Locations

3972 N Waterman Ave
Ste 104
San Bernardino, CA 92404
Phone (909) 433-9700

3972 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 433-9700

Organizations & group practices 2

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": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1689281594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25971 REED WAY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543888",
            "telephone_number": "626-731-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3972 N WATERMAN AVE STE 104",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924041767",
            "telephone_number": "909-433-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5562 Philadelphia St",
            "address_purpose": "LOCATION",
            "city": "Chino",
            "state": "CA",
            "postal_code": "917102466",
            "country_code": "US",
            "telephone_number": "713-589-5283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MA",
        "first_name": "CLAUDINE",
        "middle_name": "MAE",
        "credential": "MSN NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95015113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.