Individual provider Active NPI

Kajuana Mashieka Brintley, NP

  • Primary Care Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1770326944
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95027964 Issued in CA
Practice address
600 Coffee Rd
Modesto, CA 95355-4201
Phone
(209) 550-4726
Fax
(209) 522-1720
NPI assigned
Jun 17, 2024
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95027964 CA Primary

Addresses

Primary practice location

600 Coffee Rd
Modesto, CA 95355-4201

Mailing address

317 American Farms Ave
Lathrop, CA 95330-8652
Phone (209) 740-1440

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
I20250128001328 CA Practitioner - Nurse Practitioner 3072042662 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, shared by 24 NPIs, 2,473 clinicians

Practice addresses (Care Compare)

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Multi-Specialty CurrentSince Feb 1, 2025 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2025 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2025 Accepting new patients
Sutter Valley Medical Foundation Multi-Specialty Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2025 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Feb 1, 2025 Accepting new patients
Sutter Regional Medical Foundation Multi-Specialty Past Accepting new patients

Locations

8200 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 544-5400

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

8011 Don Ave
Stockton, CA 95209
Phone (209) 955-3001

460 Plumas Blvd
Ste 202
Yuba City, CA 95991
Phone (530) 749-5500

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": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1770326944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 AMERICAN FARMS AVE",
            "city": "LATHROP",
            "state": "CA",
            "postal_code": "953308652",
            "telephone_number": "209-740-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-550-4726",
            "fax_number": "209-522-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINTLEY",
        "first_name": "KAJUANA",
        "middle_name": "MASHIEKA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95027964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.