Individual provider Active NPI

Jennie Le Ruiz, NP-BC

  • Nurse Practitioner
  • Garden Grove, CA
National Provider Identifier
1912444688
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95003804 Issued in CA
Practice address
12001 Nieta Dr
Garden Grove, CA 92840-3523
Phone
(714) 702-0090
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 95003804 CA
Gerontology Nurse Practitioner 363LG0600X 95003804 CA
Nurse Practitioner 363L00000X 95003804 CA Primary

Addresses

Primary practice location

12001 Nieta Dr
Garden Grove, CA 92840-3523

Mailing address

12522 Lambert Rd
Whittier, CA 90606-2758
Phone (562) 967-2273

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
I20200302001338 CA Practitioner - Nurse Practitioner 2062849128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pih Health PhysiciansGroup PAC ID 8426951328, 616 clinicians

Practice addresses (Care Compare)

12522 Lambert Rd
Whittier, CA 90606-2758
Phone (562) 906-6470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003804CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pih Health Physicians Current Accepting new patients
Pih Health Physicians CurrentSince Nov 16, 2021 Accepting new patients
Bright Health Physicians of Pih CurrentSince Nov 16, 2021 Accepting new patients
Global Transitional Care, LLC CurrentSince Feb 10, 2020 Accepting new patients

Locations

5161 California Ave
Ste 200
Irvine, CA 92617
Phone (949) 543-0124

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

12522 Lambert Rd
Whittier, CA 90606
Phone (562) 789-5420

Interoperability endpoints

  • Direct secure messaging: jennieruiz@pihh.allscriptsdirect.net

Organizations & group practices 4

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 2

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": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1912444688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12522 LAMBERT RD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906062758",
            "telephone_number": "562-967-2273",
            "fax_number": "562-967-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12001 NIETA DR",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403523",
            "telephone_number": "714-702-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JENNIE",
        "middle_name": "LE",
        "name_prefix": "Mrs.",
        "credential": "NP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95003804",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95003804",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95003804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.