Individual provider Active NPI

Jennifer Matthews, NP

  • Nurse Practitioner
  • Palm Desert, CA
National Provider Identifier
1861170045
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95023854 Issued in CA
Practice address
41990 Cook St Ste 102
Palm Desert, CA 92211-6101
Phone
(760) 773-1411
Fax
(760) 773-4398
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95023854 CA Primary

Addresses

Primary practice location

41990 Cook St Ste 102
Palm Desert, CA 92211-6101

Mailing address

41990 Cook St Ste 102
Palm Desert, CA 92211-6101
Phone (760) 773-1411

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
I20240823003582 CA Practitioner - Nurse Practitioner 5799224580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Southern California Keck School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eisenhower Medical CenterGroup PAC ID 5890689657, 462 clinicians

Practice addresses (Care Compare)

39950 Vista del Sol
Rancho Mirage, CA 92270-3206
Phone (760) 340-0053

41990 Cook St
Suite A102
Palm Desert, CA 92211-6101
Phone (760) 773-1411

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95023854CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eisenhower Medical Center CurrentSince Jul 10, 2024 Accepting new patients
Eisenhower Medical Center CurrentSince Jul 10, 2024 Accepting new patients

Locations

41990 Cook St
Ste 102
Palm Desert, CA 92211
Phone (760) 773-1411

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

72201 Country Club Dr
Rancho Mirage, CA 92270
Phone (760) 340-5999

39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053

39000 Bob Hope Dr
Ofc
Rancho Mirage, CA 92270
Phone (760) 333-1813

Interoperability endpoints

  • Direct secure messaging: jmatthews13424@edirect.emc.org

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 1

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1861170045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41990 COOK ST STE 102",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116101",
            "telephone_number": "760-773-1411",
            "fax_number": "760-773-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41990 COOK ST STE 102",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116101",
            "telephone_number": "760-773-1411",
            "fax_number": "760-773-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95023854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.