Individual provider Active NPI

Marilen Loo, NP-BC

  • Family Nurse Practitioner
  • Murrieta, CA
National Provider Identifier
1891165155
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95002714 Issued in CA
Practice address
41880 Kalmia St
Suite #100
Murrieta, CA 92562-8831
Phone
(951) 461-6963
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95002714 CA Primary

Addresses

Primary practice location

41880 Kalmia St
Suite #100
Murrieta, CA 92562-8831

Mailing address

41880 Kalmia St
Suite #100
Murrieta, CA 92562-8831

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20160721002448 CA Practitioner - Nurse Practitioner 1850684218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

789 E Cooley Dr
Colton, CA 92324-4007
Phone (888) 750-0036

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

Hospital & facility affiliations

  • Kaiser Foundation Hospital Fontana/Ontario Hospital, Fontana, CA, CCN 050140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95002714CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 29, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 29, 2017 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1891165155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41880 KALMIA ST",
            "address_2": "SUITE #100",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41880 KALMIA ST",
            "address_2": "SUITE #100",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628831",
            "telephone_number": "951-461-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOO",
        "first_name": "MARILEN",
        "name_prefix": "Mrs.",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95002714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.