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JAZMIN JENAE CUNNINGHAM
NPI 1912736703
Nurse Practitioner - Pediatrics in Moreno Valley, CA

Active since July 30, 2024PECOS Enrolled
11401 HEACOCK ST STE 330, MORENO VALLEY, CA 92557(951) 247-8697 Get Directions Write a Review

NPPES record last updated: November 5, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 5, 2025, Jul 30, 2024 (2 updates tracked since 2024).

About Jazmin Jenae Cunningham NPPES

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

JAZMIN JENAE CUNNINGHAM (NPI 1912736703) is an individual pediatrics provider in Moreno Valley, California, licensed in California (NP95032520) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912736703
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameJAZMIN JENAE CUNNINGHAM
Location Address11401 HEACOCK ST STE 330Moreno Valley, CA 92557-7908
Mailing Address11175 Campus StLoma Linda, CA 92350-1700 · (909) 558-8142
Phone(951) 247-8697
Sole ProprietorNo
Enumeration DateJuly 30, 2024
Last NPPES UpdateNovember 5, 20252 updates tracked since enumeration
NPPES CertifiedNovember 5, 2025
✔ NPI 1912736703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in CA · NP95032520
11401 HEACOCK ST STE 330, Moreno Valley, CA 92557
Open in Google Maps ↗

Other Names 1

Former Name (1)Jazmin Jenae Henderson

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jazmin Jenae Cunningham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Jazmin Cunningham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Faculty Physicians And Surgeons Of Llusm
Same address
Pediatrics
11401 HEACOCK ST, SUITE 330
Moreno Valley, CA 92557
  • Reassigned Medicare billing, California enrollment
  • 2,584 clinicians in this Medicare group
NPI 1285684605 (951) 247-8697

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 92557 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
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
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.

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 Jazmin Cunningham's NPI number?

The NPI number for Jazmin Cunningham is 1912736703. It was assigned to this individual provider in the NPPES registry on July 30, 2024. The provider is also known as Jazmin Jenae Henderson.

Where is Jazmin Cunningham located?

Jazmin Cunningham practices at 11401 Heacock St Ste 330, Moreno Valley, CA 92557. The listed phone number is (951) 247-8697.

What is Jazmin Cunningham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Jazmin Cunningham enrolled in Medicare?

Yes. Jazmin Cunningham is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jazmin Cunningham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jazmin Cunningham reassigns Medicare benefits to Faculty Physicians And Surgeons Of Llusm (Moreno Valley, CA). The 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 Jazmin Cunningham'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 Jazmin Cunningham was last updated on November 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.