Active NPI
Jacqueline M Hoogervorst, AG-ACNP
- Acute Care Nurse Practitioner
- Moreno Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 95024083
- Practice address
- 26520 Cactus Ave
Moreno Valley, CA 92555-3927 - Phone
- (951) 486-4000
- NPI assigned
- Jan 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 784279 | CA | |
| Acute Care Nurse Practitioner | 363LA2100X | 95024083 | CA | Primary |
Addresses
Primary practice location
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Mailing address
33034 Clairette CT
Winchester, CA 92596-4523
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11370 Anderson St
Loma Linda, CA 92354-3450
26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Riverside Healthcare System, L.P. | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients |
Locations
81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830
25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610
26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700
28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000
3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224
44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200
901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779
Interoperability endpoints
- jhoogervorst700628@direct.llu.edu
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 and National Provider Directory roles.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Apple Valley, CA
- NPI 1205009917
-
- Family Medicine Physician
- Moreno Valley, CA
- NPI 1558788331
-
- Pediatric Cardiology Physician
- Beaumont, CA
- NPI 1871766121
-
- Orthopaedic Surgery Physician
- Loma Linda, CA
- NPI 1275582918
-
- Rehabilitation Hospital Unit
- Riverside, CA
- NPI 1053358010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1699481887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33034 CLAIRETTE CT",
"city": "WINCHESTER",
"state": "CA",
"postal_code": "925964523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26520 CACTUS AVE",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925553927",
"telephone_number": "951-486-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOGERVORST",
"first_name": "JACQUELINE",
"middle_name": "M",
"credential": "AG-ACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-30",
"last_updated": "2023-01-30",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "CA",
"license": "784279",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "CA",
"license": "95024083",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.