Individual provider Active NPI

Madelein Rae Eloriaga Lazaro, NP

  • Nurse Practitioner
  • Hacienda Heights, CA
National Provider Identifier
1730077280
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95035060 Issued in CA
Practice address
17040 Shadymeadow Dr
Hacienda Heights, CA 91745-3121
Phone
(323) 603-7654
NPI assigned
Jun 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 95035060 CA Primary

Addresses

Primary practice location

17040 Shadymeadow Dr
Hacienda Heights, CA 91745-3121

Mailing address

17040 Shadymeadow Dr
Hacienda Heights, CA 91745-3121
Phone (323) 603-7654

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
I20251125001144 CA Practitioner - Nurse Practitioner 8123510385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1513 S Grand Ave
Suite 360
Los Angeles, CA 90015-3465
Phone (213) 246-2422

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95035060CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Oncology Ca, a Professional Corporation CurrentSince Nov 28, 2025 Accepting new patients
The Oncology Institute Ca, a Professional Corporation CurrentSince Nov 28, 2025 Accepting new patients

Locations

18000 Studebaker Rd
Ste 800
Cerritos, CA 90703

900 S Main St
Ste 204
Corona, CA 92882
Phone (951) 372-2400

11100 Warner Ave
Ste 214
Fountain Vly, CA 92708
Phone (714) 594-7820

3300 E South St
Ste 304
Lakewood, CA 90805
Phone (562) 232-0550

1701 E Cesar E Chavez Ave
Ste 535
Los Angeles, CA 90033
Phone (323) 223-5900

1513 S Grand Ave
Ste 360
Los Angeles, CA 90015
Phone (213) 246-2422

399 E Highland Ave
Ste 501
Sn Bernrdno, CA 92404
Phone (909) 982-4252

425 Haaland Dr
Ste 103
Thousand Oaks, CA 91361
Phone (805) 345-2020

2067 W Vista Way
Ste 295
Vista, CA 92083
Phone (526) 735-3226

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1730077280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17040 SHADYMEADOW DR",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917453121",
            "telephone_number": "323-603-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17040 SHADYMEADOW DR",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917453121",
            "telephone_number": "323-603-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARO",
        "first_name": "MADELEIN RAE",
        "middle_name": "ELORIAGA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95035060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hacienda Heights, CA

Sources for this page

Verify at the official NPI Registry.