Individual provider Active NPI

Fely Tacataca Embrado, NP-C

  • Nurse Practitioner
  • Temecula, CA
National Provider Identifier
1902417124
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95015043 Issued in CA
Practice address
33205 Temecula Pkwy
Temecula, CA 92592-9142
Phone
(951) 303-3164
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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 NP95015043 CA Primary

Addresses

Primary practice location

33205 Temecula Pkwy
Temecula, CA 92592-9142

Mailing address

33205 Temecula Pkwy
Temecula, CA 92592-9142
Phone (951) 303-3164

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
I20210121002466 CA Practitioner - Nurse Practitioner 6002220605 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

Hospital & facility affiliations

  • Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95015043CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Kidney Consultants Inc. CurrentSince Feb 1, 2021 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Unicare Community Health Center Inc Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 16, 2023 Accepting new patients
Minuteclinic Diagnostic Medical Group of San Diego Inc CurrentSince Feb 16, 2021 Accepting new patients
Minuteclinic Diagnostic Medical Group of California Inc CurrentSince Mar 1, 2020 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
PRN Urgent Care, Inc. PastSince Dec 1, 2021 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

2760 Fletcher Pkwy
El Cajon, CA 92020
Phone 6194614411 ext. 8221

12665 Garden Grove Blvd
Ste 211
Garden Grove, CA 92843
Phone (714) 636-2890

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11370 Anderson St
#3100
Loma Linda, CA 92354
Phone (909) 796-0231

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1350 Florin Rd
Sacramento, CA 95822
Phone (916) 392-5184

2514 Berryessa Rd
San Jose, CA 95132
Phone (408) 272-1431

Interoperability endpoints

  • Direct secure messaging: ftacatacaembrado772191@direct.llu.edu
  • FHIR API: https://api.platform.athenahealth.com/21072/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1902417124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33205 TEMECULA PKWY",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925929142",
            "telephone_number": "951-303-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33205 TEMECULA PKWY",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925929142",
            "telephone_number": "951-303-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMBRADO",
        "first_name": "FELY",
        "middle_name": "TACATACA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95015043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.