Individual provider Active NPI

Robereta Prepas, CNM

  • Midwife
  • Fountain Valley, CA
National Provider Identifier
1013019934
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
246873 Issued in CA
Practice address
9930 Talbert Ave
Fountain Valley, CA 92708-5153
Phone
(714) 964-6229
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 246873 CA Primary

Addresses

Primary practice location

9930 Talbert Ave
Fountain Valley, CA 92708-5153

Mailing address

1665 Scenic Ave. Suite 100
Costa Mesa, CA 92626

Other identifiers 1

IdentifierTypeStateIssuer
002468730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
246873CAMDMidwife
989CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Talbert Medical Group, P.C. Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1013019934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 SCENIC AVE. SUITE 100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 TALBERT AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085153",
            "telephone_number": "714-964-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREPAS",
        "first_name": "ROBERETA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "246873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002468730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.