NPIMap

Individual provider Active NPI

Ernesto Leonel Sequeira Abarca Sr., M.D.

  • Nephrology Physician
  • Victorville, CA
National Provider Identifier
1831350784
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A114585 Issued in CA
Practice address
17207 Jasmine St Ste 2
Victorville, CA 92395-8322
Phone
(442) 284-0080
NPI assigned
Jun 23, 2008
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A114585 CA
Nephrology Physician 207RN0300X A114585 CA Primary

Addresses

Primary practice location

17207 Jasmine St Ste 2
Victorville, CA 92395-8322

Mailing address

17207 Jasmine St Ste 2
Victorville, CA 92395-8322
Phone (442) 284-0080

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Epic Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160822001527 CA Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Hospitalist 1456523547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Hospitalist, Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgard M Vera MD IncGroup PAC ID 3971640988, 4 clinicians

Practice addresses (Care Compare)

18300 US Hwy 18
Apple Valley, CA 92307-2206
Phone (760) 242-2311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A114585CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edgard M Vera MD Inc Nephrology CurrentSince Jul 25, 2022 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
PHC-Fort Mohave Inc Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Desert Valley Hospital, LLC Past Accepting new patients

Locations

16049 Kamana Rd
Apple Valley, CA 92307
Phone (760) 242-8311

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

17207 Jasmine St
Ste 2
Victorville, CA 92395
Phone (760) 780-4179

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: ernesto.sequeiraabarca@direct.davitaphysiciansolutions.com

Organizations & group practices 5

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 9

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1831350784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17207 JASMINE ST STE 2",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958322",
            "telephone_number": "442-284-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17207 JASMINE ST STE 2",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958322",
            "telephone_number": "442-284-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUEIRA ABARCA",
        "first_name": "ERNESTO",
        "middle_name": "LEONEL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A114585",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A114585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Direct talk",
            "address_1": "17207 Jasmine St Ste 2",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923958322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.