Individual provider Active NPI

Tenzin Ngadon, FNP, BSN, RN

  • Family Nurse Practitioner
  • Los Banos, CA
National Provider Identifier
1912324757
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95000252 Issued in CA
Practice address
821 Texas Ave
Los Banos, CA 93635-3453
Phone
(209) 826-1045
Fax
(209) 826-0952
NPI assigned
Mar 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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 95000252 CA Primary

Addresses

Primary practice location

821 Texas Ave
Los Banos, CA 93635-3453

Mailing address

737 W Childs Ave
Credentialing Department
Merced, CA 95341-6805
Phone (209) 385-5481

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
I20141206000010 CA Practitioner - Nurse Practitioner 5193047918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Contra Costa County CurrentSince Dec 5, 2024 Accepting new patients
Contra Costa County CurrentSince Dec 5, 2024 Accepting new patients
Sutter Bay Medical Foundation PastSince Nov 11, 2019 Accepting new patients

Locations

2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730

13601 San Pablo Ave
San Pablo, CA 94806
Phone (510) 231-9400

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1912324757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 W CHILDS AVE",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416805",
            "telephone_number": "209-385-5481",
            "fax_number": "209-383-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 TEXAS AVE",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353453",
            "telephone_number": "209-826-1045",
            "fax_number": "209-826-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGADON",
        "first_name": "TENZIN",
        "credential": "FNP, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-18",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95000252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.