Individual provider Active NPI

Jeanette Hogenboom, FNP

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1982144333
Registry record updated Mar 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
950006048 Issued in CA
Practice address
751 Lombardi CT
Santa Rosa, CA 95407-6798
Phone
(707) 547-2222
NPI assigned
Mar 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2017

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 950006048 CA Primary

Addresses

Primary practice location

751 Lombardi CT
Santa Rosa, CA 95407-6798

Mailing address

751 Lombardi CT
Santa Rosa, CA 95407-6798

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
I20190307003195 CA Practitioner - Nurse Practitioner 8325387335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
950006048CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Cep America-California CurrentSince Sep 1, 2024 Accepting new patients
Cep America - California CurrentSince Sep 1, 2024 Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1420 N Tracy Blvd
Tracy, CA 95376
Phone (209) 832-6018

Interoperability endpoints

  • Direct secure messaging: jhogenboom365667@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1488672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488672000000",
    "number": "1982144333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LOMBARDI CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954076798",
            "telephone_number": "707-547-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGENBOOM",
        "first_name": "JEANETTE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-05",
        "last_updated": "2017-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "950006048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.