RAQUEL JUPITER (NURSE PRACTITIONER) – Family Nurse Practitioner, NPI 1134636962

RAQUEL JUPITER (NURSE PRACTITIONER) is a healthcare provider. based in Los angeles, California. specializing in NURSE PRACTITIONER. They hold the professional credentials NURSE PRACTITIONER. They hold a License No. 95007958 (CA). The NPI Number for RAQUEL JUPITER (NURSE PRACTITIONER) is 1134636962

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
RAQUEL JUPITER (NURSE PRACTITIONER)
NPI
1134636962
Phone
(323) 541-1411
Address
808 W 58TH ST
Enumeration Date
2 January 2018
Last Update Date
16 May 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3235411400
Graduation Year
2017 (9 years ago)
PAC ID
5799030599
Group Practice PAC ID
2961482690
Professional Enrollment ID
I20180619003441
Address ID
CA900373632LO808XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

16,353 NURSE PRACTITIONER in CA

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Provider Addresses for RAQUEL JUPITER (NURSE PRACTITIONER)

  • 808, West 58th Street, Wildasin, Vermont-Slauson, Los Angeles, Los Angeles County, California, 90037, United States

    LOS ANGELES, CA 900373632

    Phone: (323) 541-1411

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $37.

Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.

Last reported payment date: 2023-10-04 • Largest payer in this snapshot: PFIZER INC. ($19).

Total Amount

$37

General + Research + Ownership

Payments

2

Total payment records

General Amount

$37

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-10-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-06-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180619003441INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90037)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961482690View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Internal MedicineNY
Physician AssistantDC
-CA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What NPI should I save for RAQUEL JUPITER (NURSE PRACTITIONER)?
Save NPI 1134636962 if you need a stable reference for RAQUEL JUPITER (NURSE PRACTITIONER).
Is RAQUEL JUPITER (NURSE PRACTITIONER)'s NPI currently valid?
The extract we use shows RAQUEL JUPITER (NURSE PRACTITIONER) as active.
Does RAQUEL JUPITER (NURSE PRACTITIONER) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for RAQUEL JUPITER (NURSE PRACTITIONER). Clinical services aligned with this taxonomy classification.
Does RAQUEL JUPITER (NURSE PRACTITIONER) practice in California?
You will see Los Angeles, California on file for RAQUEL JUPITER (NURSE PRACTITIONER) alongside any extra practice locations.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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