Individual provider Active NPI

Luminita Andronescu, M.D.

  • Specialist
  • Patton, CA
National Provider Identifier
1699856864
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A84609 Issued in CA
Practice address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone
(909) 425-7679
Fax
(909) 425-6635
NPI assigned
Oct 17, 2006
Last updated
Apr 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A84609 CA Primary

Addresses

Primary practice location

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369

Mailing address

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7679

Other practice location 1

374 E Vanderbilt Way Ste 2
San Bernardino, CA 92408-3593
Phone (909) 385-5177

Other identifiers 1

IdentifierTypeStateIssuer
00A846090MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081128000072 CA Practitioner - Internal Medicine 1759441306 Reassigns benefits to 1 organization
Practice locations: San Bernardino, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A84609CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince May 10, 2016 Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince May 10, 2016 Accepting new patients
Banipal Medical Corp PastSince Apr 17, 2020 Accepting new patients

Locations

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

3102 E Highland Ave
Ofc
Patton, CA 92369
Phone (909) 425-7000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 4

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1699856864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "374 E Vanderbilt Way Ste 2",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924083593",
            "country_code": "US",
            "telephone_number": "909-385-5177",
            "fax_number": "909-575-4344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRONESCU",
        "first_name": "LUMINITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A84609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A846090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.