Individual provider Active NPI

Maria Cuevas-Altamirano, FNP-C

  • Family Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1700456738
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95020314 Issued in CA
Practice address
17203 Jasmine St
Victorville, CA 92395
Phone
(760) 881-3377
Fax
(760) 881-3379
NPI assigned
Jun 30, 2021
Last updated
Mar 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95020314 CA Primary
Registered Nurse 163W00000X 95026305 CA

Addresses

Primary practice location

17203 Jasmine St
Victorville, CA 92395

Mailing address

17203 Jasmine St
Victorville, CA 92395
Phone (760) 881-3377

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
I20220414002005 CA Practitioner - Nurse Practitioner 2264828482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.83
Promoting interoperability
100
Improvement activities
40
Cost
78.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95026305CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Gastro Group, Inc. CurrentSince Apr 12, 2022 Accepting new patients
Diamond Pathology LLC Current Accepting new patients

Locations

12565 Hesperia Rd
Ste 1
Victorville, CA 92395
Phone (717) 991-5836

12595 Hesperia Rd
Ste 101
Victorville, CA 92395
Phone (760) 881-3377

17203 Jasmine St
Victorville, CA 92395
Phone (760) 881-3377

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1700456738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17203 JASMINE ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-881-3377",
            "fax_number": "760-881-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17203 JASMINE ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-881-3377",
            "fax_number": "760-881-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUEVAS-ALTAMIRANO",
        "first_name": "MARIA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95020314",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95026305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.