Individual provider Active NPI

Mareena Miller, FNP

  • Nurse Practitioner
  • Corona, CA
National Provider Identifier
1750824058
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95005268 Issued in CA
Practice address
818 Magnolia Ave # 202
Corona, CA 92879-3128
Phone
(909) 653-6128
NPI assigned
Nov 18, 2016
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 95005268 CA Primary

Addresses

Primary practice location

818 Magnolia Ave # 202
Corona, CA 92879-3128

Mailing address

818 Magnolia Ave # 202
Corona, CA 92879-3128
Phone (909) 653-6128

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
I20170411001100 CA Practitioner - Nurse Practitioner 3274819016 Reassigns benefits to 2 organizations

Care Compare profile

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

Practice addresses (Care Compare)

1809 W Redlands Blvd
Redlands, CA 92373-8054
Phone (909) 335-3026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95005268CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Inland Psychiatric Medical Group, Inc. CurrentSince Oct 1, 2024 Accepting new patients
El-Bershawi Medical Corp CurrentSince Mar 4, 2017 Accepting new patients
Inland Psychiatric Medical Group, Inc. Current Accepting new patients
Mitchell McDowell, D.O. Inc PastSince May 27, 2023 Accepting new patients
San Bernardino Medical Group Inc Past Accepting new patients
Pacific Professional Surgical Group Inc Past Accepting new patients

Locations

4160 Temescal Canyon Rd
Ste 408
Corona, CA 92883
Phone (951) 344-4451

11306 Mountain View Ave
Ste A
Loma Linda, CA 92354
Phone (909) 423-0408

23110 Atlantic Cir
Ste F
Moreno Valley, CA 92553
Phone (951) 243-6455

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

4049 Brockton Ave
Riverside, CA 92501
Phone (951) 300-8124

4234 Riverwalk Pkwy
Ste 230
Riverside, CA 92505
Phone (951) 373-5819

Interoperability endpoints

  • Direct secure messaging: mareena.miller.p1@direct.pacificpulm.nextgenshare.com

Organizations & group practices 7

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": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1750824058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 MAGNOLIA AVE # 202",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793128",
            "telephone_number": "909-653-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 MAGNOLIA AVE # 202",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793128",
            "telephone_number": "909-653-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MAREENA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.