Individual provider Active NPI

Jenilyn Palisoc Peros, DNP, FNP-C, MSN

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1982040515
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23695 Issued in CA
Practice address
2204 Garnet Ave Ste 209C
San Diego, CA 92109-3771
Phone
(949) 439-0455
NPI assigned
May 22, 2013
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 23695 CA Primary

Addresses

Primary practice location

2204 Garnet Ave Ste 209C
San Diego, CA 92109-3771

Mailing address

4231 Balboa Ave # 302
San Diego, CA 92117-5504
Phone (949) 439-0455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graybill Medical Group Inc CurrentSince Jul 1, 2017 Accepting new patients

Locations

625 E Grand Ave
Escondido, CA 92025
Phone (760) 745-1551

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1982040515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4231 BALBOA AVE # 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175504",
            "telephone_number": "949-439-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 GARNET AVE STE 209C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093771",
            "telephone_number": "949-439-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROS",
        "first_name": "JENILYN",
        "middle_name": "PALISOC",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "23695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.