MRS. SUSANA GUADALUPE JIMENEZ (AG-ACNP) – Acute Care Nurse Practitioner, NPI 1750854865
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for MRS. SUSANA GUADALUPE JIMENEZ (AG-ACNP)
109 STONEBROOK ST
SIMI VALLEY, CA 930655368
Phone: (818) 826-0008
Type: Mailing
1601 N SEPULVEDA BLVD
MANHATTAN BEACH, CA 902665111
Phone: (310) 658-3775
Type: Location
Eustace Street, Pacoima, Los Angeles, Los Angeles County, California, 91340, United States
PACOIMA, CA 913311809
Phone: (818) 826-0008
Type: Mailing
Burbank Boulevard, Tarzana, Los Angeles, Los Angeles County, California, 91316, United States
TARZANA, CA 913562830
Phone: (818) 345-5580
Fax: (818) 609-2834
Type: Location
124 MACAW LN
SIMI VALLEY, CA 930653152
Phone: (805) 306-0304
Fax: (805) 306-0102
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 44 Open Payments records for all available years, with a total value of $1,259.
Total Amount is formed as General ($1,259) + Research ($0) + Ownership ($0) = $1,259.
Last reported payment date: 2024-12-30 • Largest payer in this snapshot: Abbott Laboratories ($326).
Total Amount
$1,259
General + Research + Ownership
Payments
44
Total payment records
General Amount
$1,259
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $326 |
| ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) | $259 |
| CVRx, Inc. | $231 |
| Medtronic, Inc. | $169 |
| Boston Scientific Corporation | $69 |
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: 2019-08-22
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190822000610 | I | Nurse Practitioner | CA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 174 | 142 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 83 | 70 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 56 | 51 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 41 | 41 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 34 | 32 | $0 |
Insurance plans in this area (ZIP 93065)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CA | |
| - | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| Nurse Practitioner | CA | |
| - | CA | |
| - | CA | |
| - | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| Internal Medicine | CA |
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