Active NPI
Adrianne M Dela Paz, MD
- Ophthalmology Physician
- Terre Haute, IN
National Provider Identifier
1194936039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 01067357A
- Practice address
- 422 Poplar Street
Terre Haute, IN 47807-4209 - Phone
- (812) 242-3700
- Fax
- (812) 234-3565
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 01067357A | IN | Primary |
Addresses
Primary practice location
422 Poplar Street
Terre Haute, IN 47807-4209
Mailing address
221 So. 6TH Street
Terre Haute, IN 47807-4214
Phone (812) 242-3700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07901 | Medicaid | LA | |
| P00834933 | Other | IN | RAILROAD MEDICARE |
| P00834946 | Other | IN | RAILROAD MEDICARE |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01067357A | IN | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1194936039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 SO. 6TH STREET",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478074214",
"telephone_number": "812-242-3700",
"fax_number": "812-234-3565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 POPLAR STREET",
"city": "TERRE HAUTE",
"state": "IN",
"postal_code": "478074209",
"telephone_number": "812-242-3700",
"fax_number": "812-234-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELA PAZ",
"first_name": "ADRIANNE",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01067357A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07901",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00834933",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00834946",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Terre Haute, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.