Individual provider Active NPI

Joselyn Arandia Deculing, NURSE PRACTITIONER

  • Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1992135081
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23622 Issued in CA
Practice address
1234 McHenry Ave
Modesto, CA 95350-5373
Phone
(209) 544-2554
NPI assigned
Nov 26, 2013
Last updated
Dec 10, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 23622 CA
Nurse Practitioner 363L00000X 23622 CA Primary

Addresses

Primary practice location

1234 McHenry Ave
Modesto, CA 95350-5373

Mailing address

1409 Lecourbe CT
Modesto, CA 95356-8905
Phone (209) 596-4679

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
I20141112001852 CA Practitioner - Nurse Practitioner 2567684210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advance Nursing Practice Medical Group IncGroup PAC ID 5597191494, 4 clinicians

Practice addresses (Care Compare)

600 Walnut Woods CT
Modesto, CA 95356-9656
Phone (209) 872-4323

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.82 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
59.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23622CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Physician Inc. CurrentSince Aug 1, 2020 Accepting new patients
Caremore Health Plan Past Accepting new patients
Caremore Health Plan Past Accepting new patients

Locations

4568 Feather River Dr
Ste D
Stockton, CA 95219
Phone (209) 395-2360

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1992135081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 LECOURBE CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568905",
            "telephone_number": "209-596-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 MCHENRY AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505373",
            "telephone_number": "209-544-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECULING",
        "first_name": "JOSELYN",
        "middle_name": "ARANDIA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-26",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "23622",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.