Active NPI
Cristopher Bacierto, NP
- Family Nurse Practitioner
- Modesto, CA
National Provider Identifier
1790495000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95023007
- Practice address
- 3509 Coffee Rd Ste D3
Modesto, CA 95355-1357 - Phone
- (844) 227-7599
- Fax
- (855) 903-5155
- NPI assigned
- Nov 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95023007 | CA | Primary |
Addresses
Primary practice location
3509 Coffee Rd Ste D3
Modesto, CA 95355-1357
Mailing address
3820 Dragoo Park Dr
Modesto, CA 95356-1845
Phone (209) 602-4212
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | CSV | Health Information Exchange (HIE) |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241022001570 | CA | Order and Referring Only - Nurse Practitioner | 4385176817 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1790495000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3820 DRAGOO PARK DR",
"city": "MODESTO",
"state": "CA",
"postal_code": "953561845",
"telephone_number": "209-602-4212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 COFFEE RD STE D3",
"city": "MODESTO",
"state": "CA",
"postal_code": "953551357",
"telephone_number": "844-227-7599",
"fax_number": "855-903-5155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACIERTO",
"first_name": "CRISTOPHER",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-28",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95023007",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "CSV",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3509 Coffee Rd Ste D3",
"city": "Modesto",
"state": "CA",
"country_code": "US",
"postal_code": "953551357",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.