Active NPI
Madison Carly Levine, NP
- Nurse Practitioner
- San Juan Capistrano, CA
National Provider Identifier
1891382198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95037704
- Practice address
- 30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304 - Phone
- (949) 240-2272
- NPI assigned
- Dec 21, 2020
- Reactivated
- Oct 29, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95037704 | CA | Primary |
Addresses
Primary practice location
30300 Camino Capistrano
San Juan Capistrano, CA 92675-1304
Mailing address
811 Buena Vis Apt 6
San Clemente, CA 92672-5067
Phone (949) 878-8180
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260223001371 | CA | Order and Referring Only - Nurse Practitioner | 8325529977 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95037704 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764028800000",
"number": "1891382198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 BUENA VIS APT 6",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926725067",
"telephone_number": "949-878-8180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30300 CAMINO CAPISTRANO",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "926751304",
"telephone_number": "949-240-2272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVINE",
"first_name": "MADISON",
"middle_name": "CARLY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-21",
"last_updated": "2025-11-25",
"certification_date": "2025-11-25",
"deactivation_date": "2025-09-05",
"reactivation_date": "2025-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95037704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan Capistrano, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.