Individual provider Active NPI

Crisostomo Alejo Armada Jr., D.O.

  • Family Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1902823701
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5158 Issued in CA
Practice address
10399 Lemon Ave Ste 101
Rancho Cucamonga, CA 91737-3771
Phone
(909) 373-0216
Fax
(909) 373-1902
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A5158 CA Primary

Addresses

Primary practice location

10399 Lemon Ave Ste 101
Rancho Cucamonga, CA 91737-3771

Mailing address

10399 Lemon Ave Ste 101
Rancho Cucamonga, CA 91737-3771
Phone (909) 373-0216

Other identifiers 2

IdentifierTypeStateIssuer
020A51581OtherCAMEDICARE INDIVIDUAL PTAN
00AX51580OtherCAMEDI-CAL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050726000841 CA Practitioner - Family PracticePractitioner - General PracticePractitioner - Preventive Medicine 0446287981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Preventive Medicine
Education
Michigan State University College of Human Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10399 Lemon Ave
Suite 101
Rancho Cucamonga, CA 91737-3771
Phone (909) 373-0216

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A5158CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cris Armada Jr. D.O.Inc. Family Medicine CurrentSince Jul 26, 2005 Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients

Locations

10832 Laurel St
Ste 102
Rancho Cucamonga, CA 91730
Phone (909) 987-1997

10399 Lemon Ave
Ste 101
Rch Cucamonga, CA 91737
Phone (909) 373-0216

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 3

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1902823701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10399 LEMON AVE STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917373771",
            "telephone_number": "909-373-0216",
            "fax_number": "909-373-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10399 LEMON AVE STE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917373771",
            "telephone_number": "909-373-0216",
            "fax_number": "909-373-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARMADA",
        "first_name": "CRISOSTOMO",
        "middle_name": "ALEJO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "020A51581",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00AX51580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.