Individual provider Active NPI

Madison Elizabeth Souza, NP

  • Pediatric Nurse Practitioner
  • Fairfield, CA
National Provider Identifier
1801697602
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95032370 Issued in CA
Practice address
470 Chadbourne Rd Ste a
Fairfield, CA 94534-9620
Phone
(707) 419-8989
NPI assigned
Mar 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95032370 CA Primary

Addresses

Primary practice location

470 Chadbourne Rd Ste a
Fairfield, CA 94534-9620

Mailing address

450 Clipper Hill Rd
Danville, CA 94526-2308
Phone (925) 948-5510

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
I20250414003105 CA Practitioner - Nurse Practitioner 9335663129 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ole Health CurrentSince Apr 7, 2025 Accepting new patients
Ole Health CurrentSince Apr 7, 2025 Accepting new patients
Ole Health Past Accepting new patients

Locations

470 Chadbourne Rd
Ste A
Fairfield, CA 94534
Phone (707) 419-8989

1141 Pear Tree Ln
Ste 100
Napa, CA 94558
Phone (707) 254-1778

Organizations & group practices 3

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": "1742342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1801697602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLIPPER HILL RD",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945262308",
            "telephone_number": "925-948-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 CHADBOURNE RD STE A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349620",
            "telephone_number": "707-419-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "MADISON",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95032370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.