Philip Al Alibudbud, RN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NP95032777 Issued in CA

Practice address

5401 Moonlight Way
Elk Grove, CA 95758-6850

Phone

(209) 763-8058

NPI assigned

Sep 5, 2024

Last updated

Dec 4, 2024By the provider in NPPES

Sole proprietor

Yes

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

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Mariposa, CA
  • NPI 1891207684
  Medicare reassignment NPD
• Community Health Centers of America

  • Federally Qualified Health Center (FQHC)
  • Gustine, CA
  • NPI 1245105733
  NPD

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1972338382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 MOONLIGHT WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957586850",
            "telephone_number": "209-763-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 MOONLIGHT WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957586850",
            "telephone_number": "209-763-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALIBUDBUD",
        "first_name": "PHILIP",
        "middle_name": "AL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP95032777",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95022405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Alfaro
• Kimberly Alferez Robles
• Mushin Fardeen Ali
• Sina Ali, NURSE PRACTIONER
• Syed Iqbal Ali
• Vanessa N Alikhan
• All Access Eco Mt, Corp.
• All Star Premier Transportation Inc
• Allan R Au MD Inc
• Allen Transit Inc

• Gerontology Nurse Practitioner in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.