Individual provider Active NPI

Joel Luna Ceralde, FNP-C

  • Family Nurse Practitioner
  • Lake in the Hills, IL
National Provider Identifier
1770074486
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.017683 Issued in IL
Practice address
3663 Sonoma Cir
Lake in the Hills, IL 60156-6729
Phone
(224) 569-6490
NPI assigned
May 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.017683 IL Primary

Addresses

Primary practice location

3663 Sonoma Cir
Lake in the Hills, IL 60156-6729

Mailing address

3663 Sonoma Cir
Lake in the Hills, IL 60156-6729
Phone (224) 569-6490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190314000556 IL Practitioner - Nurse Practitioner 7810237641 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.017683ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Neurology, LTD CurrentSince Apr 1, 2019 Accepting new patients

Locations

22285 N Pepper Rd
Ste 401
Lake Barrington, IL 60010
Phone (847) 882-6604

Interoperability endpoints

  • Direct secure messaging: jceralde231801@direct.myadvocateaurora.org

Organizations & group practices 1

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1770074486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 SONOMA CIR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566729",
            "telephone_number": "224-569-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 SONOMA CIR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566729",
            "telephone_number": "224-569-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERALDE",
        "first_name": "JOEL",
        "middle_name": "LUNA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

Verify at the official NPI Registry.