Individual provider Active NPI

Carlos Colon Jr., MSN, NP-C

  • Primary Care Nurse Practitioner
  • Rancho Mirage, CA
National Provider Identifier
1790456465
Registry record updated Nov 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95018505 Issued in CA
Practice address
35800 Bob Hope Dr Ste 255
Rancho Mirage, CA 92270-1786
Phone
(951) 773-3379
NPI assigned
Sep 23, 2021
Last updated
Nov 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95018505 CA
Gerontology Nurse Practitioner 363LG0600X 95018505 CA
Primary Care Nurse Practitioner 363LP2300X 95018505 CA Primary

Addresses

Primary practice location

35800 Bob Hope Dr Ste 255
Rancho Mirage, CA 92270-1786

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

1085 E Ramon Rd Apt 110
Palm Springs, CA 92264-7777
Phone (760) 902-7916

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
I20211230000852 CA Practitioner - Nurse Practitioner 9638560626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1100 N Palm Canyon Dr
Palm Springs, CA 92262-4426

5957 W Ramsey St
Banning, CA 92220-3058
Phone (951) 845-0313

PO Box
Suite 35380
Las Vegas, NV 89133-5380

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
95018505CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 31, 2022 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 31, 2022 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Interoperability endpoints

  • Direct secure messaging: ccolon23085@epiclp.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763164800000",
    "number": "1790456465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35800 BOB HOPE DR STE 255",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701786",
            "telephone_number": "951-773-3379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1085 E Ramon Rd Apt 110",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922647777",
            "country_code": "US",
            "telephone_number": "760-902-7916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLON",
        "first_name": "CARLOS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSN, NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-23",
        "last_updated": "2025-11-15",
        "certification_date": "2025-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95018505",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95018505",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95018505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.