NPIMap

Individual provider Active NPI

Irina Vancea, MD

  • Nephrology Physician
  • Pueblo, CO
National Provider Identifier
1205919750
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
46605 Issued in CO
Practice address
3426 Lake Ave
Ste 120
Pueblo, CO 81004-3877
Phone
(719) 561-5264
Fax
(719) 561-5272
NPI assigned
Oct 20, 2006
Last updated
Apr 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 46605 CO Primary

Addresses

Primary practice location

3426 Lake Ave
Ste 120
Pueblo, CO 81004-3877

Mailing address

3426 Lake Ave
Ste 120
Pueblo, CO 81004-3877

Other identifiers 1

IdentifierTypeStateIssuer
08252866MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080730000708 CO Practitioner - NephrologyPractitioner - Internal Medicine 5496829095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Washington School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Colorado Nephrology Assoc PCGroup PAC ID 5395636161, 7 clinicians

Practice addresses (Care Compare)

3426 Lake Ave
Suite 120
Pueblo, CO 81004-3878
Phone (719) 561-5264

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.69 of 100Reported as group
Quality
70.43
Promoting interoperability
100
Improvement activities
40
Cost
78.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46605COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Nephrology Assoc PC CurrentSince Jul 1, 2008 Accepting new patients

Locations

3426 Lake Ave
Ste 120
Pueblo, CO 81004
Phone (719) 561-5264

Interoperability endpoints

  • Direct secure messaging: ivancea32131@direct.acumenmd.com

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1205919750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3426 LAKE AVE",
            "address_2": "STE 120",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3426 LAKE AVE",
            "address_2": "STE 120",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043877",
            "telephone_number": "719-561-5264",
            "fax_number": "719-561-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCEA",
        "first_name": "IRINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "46605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08252866",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.