Individual provider Active NPI

Jared Jermaine Lumanauw-Ford

  • Acute Care Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1851026041
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95021632 Issued in CA
Practice address
435 H St
Chula Vista, CA 91910-4307
Phone
(858) 260-7825
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95021632 CA Primary

Addresses

Primary practice location

435 H St
Chula Vista, CA 91910-4307

Mailing address

7800 Westside Dr Apt 104
San Diego, CA 92108-1217
Phone (706) 332-8850

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
I20221130000003 CA Practitioner - Nurse Practitioner 5395113005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scripps Health Inpatient Providers Medical Group IncGroup PAC ID 9436314762, 209 clinicians

Practice addresses (Care Compare)

435 H St
Chula Vista, CA 91910-4307
Phone (619) 691-7000

9888 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 626-4123

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Mercy Hospital Hospital, San Diego, CA, CCN 050077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95021632CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Inpatient Providers Medical Group Inc. CurrentSince Sep 15, 2022 Accepting new patients
Scripps Health Current Accepting new patients

Locations

435 H St
Chula Vista, CA 91910
Phone (619) 691-7000

10140 Campus Point Dr
San Diego, CA 92121
Phone (858) 678-7049

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.

Hospital & facility affiliations 2

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851026041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7800 WESTSIDE DR APT 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081217",
            "telephone_number": "706-332-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 H ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104307",
            "telephone_number": "858-260-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMANAUW-FORD",
        "first_name": "JARED",
        "middle_name": "JERMAINE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95021632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.