Individual provider Active NPI

Jonathan Manuel Madamba, FNP-BC

  • Family Nurse Practitioner
  • Cerritos, CA
National Provider Identifier
1982492229
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95030718 Issued in CA
Practice address
19020 Allingham Ave
Cerritos, CA 90703-6405
Phone
(562) 739-3505
NPI assigned
Apr 28, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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 NP95030718 CA Primary

Addresses

Primary practice location

19020 Allingham Ave
Cerritos, CA 90703-6405

Mailing address

19020 Allingham Ave
Cerritos, CA 90703-6405

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
I20250514003203 CA Practitioner - Nurse Practitioner 5092233999 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95030718CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Health Plan of California, Inc. CurrentSince Jun 2, 2025 Accepting new patients
Molina Healthcare of California CurrentSince Jun 2, 2025 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

Interoperability endpoints

  • Direct secure messaging: jmadamba18915@direct-prd.molinahealthcare.com

Organizations & group practices 2

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1982492229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 ALLINGHAM AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 ALLINGHAM AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036405",
            "telephone_number": "562-739-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADAMBA",
        "first_name": "JONATHAN MANUEL",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95030718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.