Individual provider Active NPI

Carlos E Ferrufino, FNP

  • Family Nurse Practitioner
  • Palmdale, CA
National Provider Identifier
1740735232
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021685 Issued in CA
Practice address
41203 Crispi LN
Palmdale, CA 93551-1928
Phone
(818) 237-8961
NPI assigned
Aug 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 16-550 CA
Family Nurse Practitioner 363LF0000X 95021685 CA Primary

Addresses

Primary practice location

41203 Crispi LN
Palmdale, CA 93551-1928

Mailing address

41203 Crispi LN
Palmdale, CA 93551-1928
Phone (818) 237-8961

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
I20240514001437 CA Practitioner - Nurse Practitioner 4789025354 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16-550CAMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bartz-Altadonna Community Health Center CurrentSince Mar 27, 2024 Accepting new patients
Bartz-Altadonna Community Health Center CurrentSince Mar 27, 2024 Accepting new patients

Locations

12560 Boron Ave
Boron, CA 93516
Phone (760) 762-5064

43322 Gingham Ave
Ste 105
Lancaster, CA 93535
Phone (661) 874-4029

43210 Gingham Ave
Lancaster, CA 93535
Phone 6618744050222

43322 Gingham Ave
Lancaster, CA 93535
Phone (661) 579-9317

2520 E Palmdale Blvd
Ste A
Palmdale, CA 93550

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": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1740735232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41203 CRISPI LN",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511928",
            "telephone_number": "818-237-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41203 CRISPI LN",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511928",
            "telephone_number": "818-237-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRUFINO",
        "first_name": "CARLOS",
        "middle_name": "E",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-24",
        "last_updated": "2022-11-18",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "CA",
            "license": "16-550",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.