Individual provider Active NPI

Dorothy R Correia, N.P.

  • Family Nurse Practitioner
  • Fairfield, CA
National Provider Identifier
1215070339
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20514 Issued in CA
Practice address
1860 Pennsylvania Ave Ste 200
Fairfield, CA 94533-3550
Phone
(707) 646-4180
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20514 CA Primary

Addresses

Primary practice location

1860 Pennsylvania Ave Ste 200
Fairfield, CA 94533-3550

Mailing address

131 Sunset Ave Ste E-165
Suisun City, CA 94585-6345
Phone (707) 646-4180

Other identifiers 1

IdentifierTypeStateIssuer
951584MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200107002708 CA Practitioner - Nurse Practitioner 5698706695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

1000 Nut Tree Rd
Vacaville, CA 95687-4100
Phone (707) 624-7000

1020 Nut Tree Rd
Vacaville, CA 95687-4100

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 429-3600

1860 Pennsylvania Ave
Fairfield, CA 94533-3550

1860 Pennsylvania Ave
Fairfield, CA 94533-3590
Phone (707) 646-4114

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20514CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Dec 16, 2019 Accepting new patients
Northbay Healthcare Group CurrentSince Dec 16, 2019 Accepting new patients
Northbay Health Medical Foundation CurrentSince Jan 1, 2026 Accepting new patients

Locations

1860 Pennsylvania Ave
Ste 110
Fairfield, CA 94533
Phone (707) 254-9693

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1860 Pennsylvania Ave
Ste 200
Fairfield, CA 94533
Phone (707) 427-5211

4500 Business Center Dr
Fairfield, CA 94534
Phone (707) 646-4777

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Organizations & group practices 3

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1215070339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 SUNSET AVE STE E-165",
            "city": "SUISUN CITY",
            "state": "CA",
            "postal_code": "945856345",
            "telephone_number": "707-646-4180",
            "fax_number": "707-646-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE STE 200",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333550",
            "telephone_number": "707-646-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREIA",
        "first_name": "DOROTHY",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2021-01-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "951584",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.