Susan De Jesus Quilalang, NP RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5579 Issued in CA

Practice address

1637 3Rd Ave
Chula Vista, CA 91910

Phone

(619) 205-1360

Fax

(619) 205-1376

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centro de Salud de la Comunidad de San Ysidro,Inc.Group PAC ID 6901709435, 291 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment Care Compare group NPD
• Centro de Salud de la Comunidad de San Ysidro Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  • PACE Provider Organization
  • San Ysidro, CA
  • NPI 1265843122
  NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1841200482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PRECISION PARK LN",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921731345",
            "telephone_number": "619-662-4100",
            "fax_number": "619-428-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 3RD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91910",
            "telephone_number": "619-205-1360",
            "fax_number": "619-205-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILALANG",
        "first_name": "SUSAN",
        "middle_name": "DE JESUS",
        "credential": "NP RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "3714880",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "5579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "FHC11992H",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stevie L Quaranta, CCC-SLP
• Meghan Mary Quash
• Claudia Nelly Quevedo, DPT
• Elaine Quiambao
• Sabrina Jane Infante Quiapo
• Flaviana Quilinderino
• William Henry Quillin, MD
• Mylani Ysa Quinata
• Marina Quinci
• Berta Elisa N Quinones

• Nurse Practitioner in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.
• 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.