NPIMap

Individual provider Active NPI

Vivian Partida, DO

  • Internal Medicine Physician
  • Shiprock, NM
National Provider Identifier
1306349188
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17996 Issued in CA
Practice address
US Hwy 491 North
Shiprock, NM 87420
Phone
(505) 368-6001
NPI assigned
Mar 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17996 CA Primary

Addresses

Primary practice location

US Hwy 491 North
Shiprock, NM 87420

Mailing address

PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200806002800 CA Practitioner - Internal Medicine 6103256789 Reassigns benefits to 1 organization
I20221216001647 TX Practitioner - Internal Medicine 6103256789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

975 Sereno Dr
Vallejo, CA 94589-2441
Phone (707) 651-1000

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17996CAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Oct 24, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 20, 2020 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 20, 2020 Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Mar 2, 2026 Accepting new patients
Permanente Medical Group, Inc CurrentSince Mar 2, 2026 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Oct 24, 2022 Accepting new patients

Locations

4733 W Sunset Blvd
Fl 3
Los Angeles, CA 90027
Phone (323) 783-1431

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Interoperability endpoints

  • Direct secure messaging: vivian.partidamddol.p1@direct.jwch.nextgenshare.com

Organizations & group practices 8

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 8

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": "1521244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1306349188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 NORTH",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARTIDA",
        "first_name": "VIVIAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-17",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "17996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

Verify at the official NPI Registry.