Individual provider Active NPI

Ron Pascual, FAMILY NURSE PRACT.

  • Family Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1821544974
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95005248 Issued in CA
Practice address
255 N White Rd Ste 200
San Jose, CA 95127-1966
Phone
(408) 503-7600
NPI assigned
Aug 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07161095 CA
Family Nurse Practitioner 363LF0000X 95005248 CA Primary

Addresses

Primary practice location

255 N White Rd Ste 200
San Jose, CA 95127-1966

Mailing address

12900 Park Plaza Dr Ste 150
Cerritos, CA 90703-9329

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
I20170929002688 CA Practitioner - Nurse Practitioner 9335414317 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95005248CAMDFamily Nurse Practitioner
F07161095CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of California Inc Family CurrentSince May 3, 2021 Accepting new patients
SNF Specialists Medical Corporation CurrentSince Aug 1, 2020 Accepting new patients

Locations

1255 Travis Blvd
Fairfield, CA 94533
Phone (707) 425-0623

987 E Hillsdale Blvd
Foster City, CA 94404
Phone (650) 570-4631

1350 Florin Rd
Sacramento, CA 95822
Phone (916) 392-5184

1900 19th Ave
San Francisco, CA 94116
Phone (415) 664-1834

2514 Berryessa Rd
San Jose, CA 95132
Phone (408) 272-1431

2455 San Ramon Valley Blvd
San Ramon, CA 94583
Phone (925) 820-7325

Interoperability endpoints

  • Direct secure messaging: rpascual197292@santaclaravalley.direct-ci.net
  • Direct secure messaging: rpascual359361@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1821544974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N WHITE RD STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951271966",
            "telephone_number": "408-503-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCUAL",
        "first_name": "RON",
        "credential": "FAMILY NURSE PRACT.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-29",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F07161095",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.