Individual provider Active NPI

Jasmine Lukose Punnoose, FNP-BC

  • Family Nurse Practitioner
  • Camarillo, CA
National Provider Identifier
1851805253
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209016562 Issued in IL
Practice address
150 Ripley St
Camarillo, CA 93010-2618
Phone
(773) 308-3716
NPI assigned
Nov 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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 209016562 IL Primary
Family Nurse Practitioner 363LF0000X 95019364 CA

Addresses

Primary practice location

150 Ripley St
Camarillo, CA 93010-2618

Mailing address

150 Ripley St
Camarillo, CA 93010-2618
Phone (773) 308-3716

Other practice location 1

21660 W Field Pkwy
Deer Park, IL 60010-7265
Phone (888) 803-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260108002171 CA Practitioner - Nurse Practitioner 8820574940 Reassigns benefits to 1 organization
I20260512002163 IL Practitioner - Nurse Practitioner 8820574940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

331 1St St a
San Francisco, CA 94105-2661

333 1St St
Suite a
San Francisco, CA 94105-3060

440 Franklin St
Bloomfield, NJ 07003-4378

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95019364CAMDFamily Nurse Practitioner
209016562ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Medical Care of California CurrentSince Jan 1, 2025 Accepting new patients

Locations

415 N Crescent Dr
Ste 320
Beverly Hills, CA 90210
Phone (415) 510-2755

333 1st St
Ste A
San Francisco, CA 94105
Phone (312) 724-7441

21660 W Field Pkwy
Deer Park, IL 60010
Phone (312) 620-1803

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1851805253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 RIPLEY ST",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102618",
            "telephone_number": "773-308-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 RIPLEY ST",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102618",
            "telephone_number": "773-308-3716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21660 W Field Pkwy",
            "address_purpose": "LOCATION",
            "city": "Deer Park",
            "state": "IL",
            "postal_code": "600107265",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUNNOOSE",
        "first_name": "JASMINE",
        "middle_name": "LUKOSE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016562",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.