Individual provider Active NPI

Maria Vacarella, C.N.M.

  • Advanced Practice Midwife
  • Bend, OR
National Provider Identifier
1063725703
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
201050134NP Issued in OR
Practice address
2330 NE Division St
Suite 7
Bend, OR 97701-3530
Phone
(503) 775-4931
Fax
(503) 788-7285
NPI assigned
Jul 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 201050134NP OR Primary

Addresses

Primary practice location

2330 NE Division St
Suite 7
Bend, OR 97701-3530

Mailing address

3727 NE Martin Luther King Jr Blvd
Attn: Credentialing
Portland, OR 97212-1112
Phone (503) 775-4931

Other identifiers 1

IdentifierTypeStateIssuer
500624036MedicaidOR

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)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
201050134NPORMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1063725703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 NE MARTIN LUTHER KING JR BLVD",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121112",
            "telephone_number": "503-775-4931",
            "fax_number": "503-788-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 NE DIVISION ST",
            "address_2": "SUITE 7",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013530",
            "telephone_number": "503-775-4931",
            "fax_number": "503-788-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACARELLA",
        "first_name": "MARIA",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201050134NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500624036",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.