Abraham Alejandro Vandiver, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95011167 Issued in CA

Practice address

488 E Valley Pkwy Ste 411
Escondido, CA 92025-3380

Phone

(833) 867-4642

Fax

(360) 462-2741

NPI assigned

Dec 31, 2018

Sex

Male

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

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles (7 of 8)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: abraham.vandiver.p1@direct.cdsdp.nextgenshare.com

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.

• Neighborhood Healthcare

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1598703647
  Medicare reassignment Care Compare group NPD
• Clinicas de Salud del Pueblo, Inc

  • Federally Qualified Health Center (FQHC)
  • El Centro, CA
  • NPI 1346313889
  Medicare reassignment NPD
• Imperial Valley Family Care Medical Group Apc

  • General Practice Physician
  • Imperial, CA
  • NPI 1275581894
  Medicare reassignment NPD
• Clinicas de Salud del Pueblo Inc.

  • Community/Retail Pharmacy
  • El Centro, CA
  • NPI 1962045872
  NPD
• Clinicas de Salud del Pueblo, Inc

  • Federally Qualified Health Center (FQHC)
  • El Centro, CA
  • NPI 1487741773
  NPD
• Imperial Valley Family Care Medical Group, Apc

  • Cardiac Rehabilitation Registered Nurse
  • Imperial, CA
  • NPI 1750112587
  NPD
• Neighborhood Healthcare

  • Federally Qualified Health Center (FQHC)
  • Beaumont, CA
  • NPI 1629601653
  NPD

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1982176947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 RIVERVIEW AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439109",
            "telephone_number": "760-960-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 E VALLEY PKWY STE 411",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253380",
            "telephone_number": "833-867-4642",
            "fax_number": "360-462-2741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 S Imperial Ave",
            "address_purpose": "LOCATION",
            "city": "El Centro",
            "state": "CA",
            "postal_code": "922434242",
            "country_code": "US",
            "telephone_number": "760-339-2802",
            "fax_number": "760-339-2829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "ABRAHAM",
        "middle_name": "ALEJANDRO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-31",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "820909",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Van Goethem
• Melissa Van Grol, LCSW, PPSC
• Ruth Elaine Van Hasselt, SLP
• Sarah Van Woert
• Danielle Vanderford
• Christopher Tan Vanichsarn, M.D.
• Krystal Tan Vanichsarn, O.D.
• Khrystina Varela, PPS
• Giselle Vargas Cortez
• Annabelle Vargas

• Family Nurse Practitioner in Escondido, CA
• Providers in Escondido, 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 Feb 12, 2025; 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.