Individual provider Active NPI

Edielyn Layag Quijano, NP

  • Family Nurse Practitioner
  • Baldwin Park, CA
National Provider Identifier
1982974705
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20718 Issued in CA
Practice address
14051 Ramona Pkwy
Baldwin Park, CA 91706-4114
Phone
(626) 960-3753
NPI assigned
Jan 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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 20718 CA Primary

Addresses

Primary practice location

14051 Ramona Pkwy
Baldwin Park, CA 91706-4114

Mailing address

14051 Ramona Pkwy
Baldwin Park, CA 91706-4114
Phone (626) 960-3753

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
I20141030000028 CA Practitioner - Nurse Practitioner 7719108067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baldwin Park Medical Clinic IncGroup PAC ID 9133350093, 2 clinicians

Practice addresses (Care Compare)

14051 Ramona Pkwy
Baldwin Park, CA 91706-4114
Phone (626) 960-3753

600 N Garfield Ave
Suite 111
Monterey Park, CA 91754-1167

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20718CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Park Medical Clinic Inc CurrentSince Aug 16, 2014 Accepting new patients
M.D. Medical Center, Inc CurrentSince Aug 16, 2014 Accepting new patients
Samia Ateia MD Inc Baldwin Medical Clinic Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients

Locations

14135 Francisquito Ave
Ste 106
Baldwin Park, CA 91706
Phone (626) 960-3753

14051 Ramona Pkwy
Baldwin Park, CA 91706
Phone (626) 338-7338

600 N Garfield Ave
Ste 111
Monterey Park, CA 91754
Phone (626) 280-3651

600 N Garfield Ave
Ste 11
Monterey Park, CA 91754

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1982974705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14051 RAMONA PKWY",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064114",
            "telephone_number": "626-960-3753",
            "fax_number": "626-962-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14051 RAMONA PKWY",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917064114",
            "telephone_number": "626-960-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIJANO",
        "first_name": "EDIELYN",
        "middle_name": "LAYAG",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin Park, CA

Sources for this page

Verify at the official NPI Registry.