Susana Guadalupe Jimenez, AG-ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95010834 Issued in CA

Practice address

124 Macaw LN
Simi Valley, CA 93065-3152

Phone

(805) 306-0304

Fax

(805) 306-0102

NPI assigned

Jan 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adventist Health Physicians NetworkGroup PAC ID 3274580972, 628 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Adventist Health Physicians Network

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1083976294
  Medicare reassignment Care Compare group NPD
• Sansum Clinic

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1154354504
  Medicare reassignment NPD
• Adventist Health Physicians Network

  • Physical Therapy Clinic/Center
  • Paradise, CA
  • NPI 1134092190
  NPD
• Adventist Health Physicians Network

  • Family Medicine Physician
  • Simi Valley, CA
  • NPI 1669138947
  NPD
• Sansum Clinic

  • Ambulatory Surgical Clinic/Center
  • Santa Barbara, CA
  • NPI 1144648015
  NPD
• Sansum Clinic

  • Multi-Specialty Clinic/Center
  • Santa Barbara, CA
  • NPI 1932121514
  NPD
• Beachwood Home Health

  • Home Health Agency
  • Chatsworth, CA
  • NPI 1538659933
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Simi Valley Hospital and Health Care Services

  • General Acute Care Hospital
  • Simi Valley, CA
  • NPI 1063495190
  Care Compare affiliation

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1750854865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MACAW LN",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653152",
            "telephone_number": "805-306-0304",
            "fax_number": "805-306-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MACAW LN",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653152",
            "telephone_number": "805-306-0304",
            "fax_number": "805-306-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "SUSANA",
        "middle_name": "GUADALUPE",
        "name_prefix": "Mrs.",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95010834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Rose Jeske, LVN
• Alanna Jespersen, MS CCC-SLP
• Simran Jewan
• Jill Magoffin-Doula LLC
• Arelys Jimenez
• JJ&R Emergency Medical Group of California, Inc.
• JLM Pharmacy Inc (Home Care Pharmacy)
• Jobet Corporation (Dedicated Home Health Care)
• Joerns Healthcare LLC
• Mikaela Johnson Johnson Vaal

• Acute Care Nurse Practitioner in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.