Yvonne Carlo Medock, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11606 Issued in CA

Practice address

190 E. Highland Ave
San Bernardino, CA 92404-3658

Phone

(909) 882-4788

Fax

(909) 882-8819

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: yvonne.medock.p1@direct.caremorewest.nextgenshare.com
• Direct secure messaging: yvonne.medock.1@32527.direct.athenahealth.com

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.

• Albion Medical Partners of California West P C

  • Internal Medicine Physician
  • Cerritos, CA
  • NPI 1073110607
  Medicare reassignment NPD

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1700948924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191",
            "fax_number": "909-882-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E. HIGHLAND AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043658",
            "telephone_number": "909-882-4788",
            "fax_number": "909-882-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDOCK",
        "first_name": "YVONNE",
        "middle_name": "CARLO",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006841",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "11606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01805640-DU5182",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL COLTON EFF 7/25/16",
            "identifier": "07252016",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-SAN BERNARDINO",
            "identifier": "P01288547/DU4034",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF:2/21/13-FONTANA",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF.4/23/13-S.RIVERS",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFF:2/21/13 SAN BERN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Marie Medina
• Nereida Medina
• Rebecca Medina, MHS
• Yesenia Medina
• Medmile Inc
• Medpro Interpreting
• Yessica Priscila Medrano Corona, MSW
• Mariela Aguilera Medrano, LMFT
• Medrx Pharma Inc
• Medrx Pharma Inc

• Nurse Practitioner in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.