Samuel Advincula

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95003591 Issued in CA

Practice address

18300 US Highway 18
Apple Valley, CA 92307-2206

Phone

(760) 946-8876

NPI assigned

Jan 8, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834

  CA

  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542

  CA

  Medicare reassignment NPD
• Riverside Emergency Physicians Medical Group

  • Emergency Medicine Physician
  • Riverside, CA
  • NPI 1972539039

  CA

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Care Compare group
• Southern California Permanente Medical Group

  • Clinical Medical Laboratory
  • N Hollywood, CA
  • NPI 1891873303
  Care Compare group
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Woodland Hills, CA
  • NPI 1952333478
  Care Compare group
• Cep America - California

  • Emergency Medicine Physician
  • Apple Valley, CA
  • NPI 1104871623
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hemet, CA
  • NPI 1013433465
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical Group 11,250 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1962868844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 MCCALL DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928818451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "760-946-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADVINCULA",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-08",
        "last_updated": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Adams, CNIM
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• Afp Drug Store Inc
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• Christopher Bryan Agard, M.S.

• All providers in Apple Valley, CA
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.