Renuka Rajiv, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95031599 Issued in CA

Practice address

949 Palm Ave
Imperial Beach, CA 91932-1503

Phone

(619) 429-3733

NPI assigned

Oct 18, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imperial Beach Community ClinicGroup PAC ID 6709867880, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EBEEDD
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10012052

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.

• Imperial Beach Community Clinic

  dba Imperial Beach Health Center

  • Community Health Clinic/Center
  • Imperial Beach, CA
  • NPI 1790718351
  Medicare reassignment Care Compare group NPD
• Imperial Beach Community Clinic

  dba Nestor Community Health Center

  • Community Health Clinic/Center
  • San Diego, CA
  • NPI 1215246996
  NPD

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1821819301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 3RD AVE UNIT 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034126",
            "telephone_number": "857-203-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 PALM AVE",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919321503",
            "telephone_number": "619-429-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJIV",
        "first_name": "RENUKA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "F02240409",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Petrie
• Vernon Greg Phillips, MD
• Frances McDonald Pratte, LMFT
• Prosperous Health Imperial Beach, LLC
• Michael Steve Quirozayala
• RDN Foundation Inc.
• Christina Reiter, CNM
• Danielle Richardson, M.D.
• Alonzo Milton Riley, SUDRC
• Angel David Esparza Rios

• Family Nurse Practitioner in Imperial Beach, CA
• Providers in Imperial Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.