Individual provider Active NPI

Rabeca Vatamaniuc, CARE GIVER

  • Home Health Aide
  • Surprise, AZ
National Provider Identifier
1124374715
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
AL8491H Issued in AZ
Practice address
11151 W Lily McKinley Dr
Surprise, AZ 85378
Phone
(623) 972-4728
Fax
(623) 972-1467
NPI assigned
Aug 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X AL8491H AZ Primary

Addresses

Primary practice location

11151 W Lily McKinley Dr
Surprise, AZ 85378

Mailing address

11151 W Lily McKinley Dr
Surprise, AZ 85378
Phone (623) 972-4728

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

State licenses

LicenseStateTypeSpecialty
AL8491HAZMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1124374715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11151 W LILY MCKINLEY DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85378",
            "telephone_number": "623-972-4728",
            "fax_number": "623-972-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11151 W LILY MCKINLEY DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85378",
            "telephone_number": "623-972-4728",
            "fax_number": "623-972-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VATAMANIUC",
        "first_name": "RABECA",
        "credential": "CARE GIVER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "AZ",
            "license": "AL8491H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.