Edvina Samkeliso Fuyana

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

213866 Issued in GA

Practice address

17981 Sky Park Cir BLDG 39
Irvine, CA 92614-6309

Phone

(877) 896-7350

NPI assigned

May 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Advantmed Provider Network

  • General Practice Physician
  • Irvine, CA
  • NPI 1710409719
  NPD

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1972187482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17981 SKY PARK CIR BLDG 39",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146309",
            "telephone_number": "877-896-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17981 SKY PARK CIR BLDG 39",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146309",
            "telephone_number": "877-896-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUYANA",
        "first_name": "EDVINA",
        "middle_name": "SAMKELISO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "95017106",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "213866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Furbush, MS OTR L
• Jeanne E Furnier, PHARM.D.
• Junko Fuse
• George Fushiki
• Maria Elena Fuster, PHD, LMFT, ATR-BC
• Sheba Gabrail, M.D.
• Marianna Helen Gabriel, RD CHES
• Gabriela Pulido, LMFT Inc
• Padmaja Gadadoss
• Shelly A Gadea

• Family Nurse Practitioner in Irvine, CA
• Providers in Irvine, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.