Individual provider Active NPI

Inosi Vatucicila, MBBS

  • Obstetrics Physician
  • Pago Pago, AS
National Provider Identifier
1013617109
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
5100C Issued in AS
Practice address
11155 Turner Drive
Pago Pago, AS 94565-9456
Phone
(684) 633-1222
Fax
(684) 633-1869
NPI assigned
Mar 7, 2023
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 5100C AS Primary

Addresses

Primary practice location

11155 Turner Drive
Pago Pago, AS 94565-9456

Mailing address

PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 633-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122003305 AS Practitioner - Obstetrics/Gynecology 9537511936 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5100CASMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Samoa Medical Center CurrentSince Nov 27, 2023 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1013617109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11155 TURNER DRIVE",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "945659456",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATUCICILA",
        "first_name": "INOSI",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "AS",
            "license": "5100C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pago Pago, AS

Sources for this page

Verify at the official NPI Registry.