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ETHLENE EVETTE DADE FNP
NPI 1417649013
Nurse Practitioner - Family in Long Beach, CA

Active since May 23, 2023PECOS Enrolled
200 OCEANGATE STE 100, LONG BEACH, CA 90802(760) 936-7118 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 16, 2025, Jun 12, 2025, May 23, 2023 (3 updates tracked since 2023).

About Ethlene Evette Dade Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHLENE EVETTE DADE FNP (NPI 1417649013) is an individual family provider in Long Beach, California, licensed in California (95025043) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1417649013
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameETHLENE EVETTE DADECredential: FNP
Location Address200 OCEANGATE STE 100Long Beach, CA 90802-4317
Mailing Address14390 Dalton CtVictorville, CA 92394-3212 · (323) 973-3647
Phone(760) 936-7118
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 23, 2023
Last NPPES UpdateDecember 16, 20253 updates tracked since enumeration
NPPES CertifiedDecember 16, 2025
✔ NPI 1417649013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses✔ Licensed in CA · 95025043✔ Licensed in TX · 1208802
200 OCEANGATE STE 100, Long Beach, CA 90802
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethlene Evette Dade Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133582646
PECOS Enrollment IDI20251216004108, I20260604002533
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

5

Medicare enrollment records show Ethlene Dade reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Molina Healthcare Of California
Same address
Health Maintenance Organization
200 OCEANGATE STE 100
Long Beach, CA 90802
  • Reassigned Medicare billing, California enrollment
  • 339 clinicians in this Medicare group
NPI 1194811760 (562) 499-6191
Molina Care Connections, LLC.
Same address
Nurse Practitioner
200 OCEANGATE STE 100
Long Beach, CA 90802
  • Reassigned Medicare billing, Illinois and Texas enrollments
  • 74 clinicians in this Medicare group
NPI 1407243223 (888) 562-5442
Providence Medical Foundation
17 mi
Family Medicine
200 W CENTER STREET PROMENADE
Anaheim, CA 92805
  • Reassigned Medicare billing, California enrollment
  • 1,699 clinicians in this Medicare group
NPI 1639715709 (147) 123-5007
Central Health Plan Of California, Inc.
26 mi
Health Maintenance Organization
1540 BRIDGEGATE DR
Diamond Bar, CA 91765
  • Reassigned Medicare billing, California enrollment
  • 283 clinicians in this Medicare group
NPI 1386714772 (626) 388-2390
Molina Healthcare Of Washington, Inc
991 mi
Family Medicine
21540 30TH DR SE STE 400
Bothell, WA 98021
  • Reassigned Medicare billing, Washington enrollment
  • 207 clinicians in this Medicare group
NPI 1659897163 (888) 562-5442

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90802 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOLINA MEDICAL GROUP OF NEW MEXICO, PC
Family Medicine
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (562) 499-6191
DARLENA THACH FNP-C
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (888) 562-5442
JOANNA DURON FNP
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (760) 718-5648
JENNIFER M DONALDSON
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (888) 562-5442
MELISSA STEWART LCSW
Social Worker (Clinical)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (860) 255-4640
DAISY O ALVARADO FNP-C, RN, PHN, CBN
Nurse Practitioner (Family)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (951) 660-6224
MRS. CHARLYNE GABRIEL-JACQUES ARNP
Nurse Practitioner (Psychiatric/Mental Health)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (305) 382-4161
ALYSSA AREEPRACHAPIROM
Nurse Practitioner (Psychiatric/Mental Health)
200 OCEANGATE STE 100
LONG BEACH, CA 90802
Los Angeles County (888) 562-5442

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethlene Dade's NPI number?

The NPI number for Ethlene Dade is 1417649013. It was assigned to this individual provider in the NPPES registry on May 23, 2023.

Where is Ethlene Dade located?

Ethlene Dade practices at 200 Oceangate Ste 100, Long Beach, CA 90802. The listed phone number is (760) 936-7118.

What is Ethlene Dade's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Ethlene Dade enrolled in Medicare?

Yes. Ethlene Dade is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Ethlene Dade's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethlene Dade reassigns Medicare benefits to 5 organizations: Molina Healthcare Of California (Long Beach, CA), Molina Care Connections, LLC. (Long Beach, CA), Providence Medical Foundation (Anaheim, CA), Central Health Plan Of California, Inc. (Diamond Bar, CA) and Molina Healthcare Of Washington, Inc (Bothell, WA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethlene Dade's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ethlene Dade was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.