Individual provider Active NPI

Patricia Suzanne Dostalek, CNM

  • Advanced Practice Midwife
  • Tucson, AZ
National Provider Identifier
1306808670
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
080636 Issued in AZ
Practice address
5301 E Grant Rd
Obstetrix Medical Group of Az, P.C.
Tucson, AZ 85712-2805
Phone
(520) 881-3936
Fax
(520) 795-0626
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 080636 AZ Primary

Addresses

Primary practice location

5301 E Grant Rd
Obstetrix Medical Group of Az, P.C.
Tucson, AZ 85712-2805

Mailing address

PO Box 30280
Obstetrix Medical Group of Az, P.C.
Tucson, AZ 85751-0280
Phone (520) 881-3936

Other identifiers 7

IdentifierTypeStateIssuer
157924MedicaidAZ
080636OtherAZRN LICENSE
166OtherHIAPRN RECOGNITION
102OtherCANURSE MIDWIFE CERTIFICATE
216287OtherCARN LICENSE
00145OtherAZARNP CERTIFICATE
40189OtherHIRN LICENSE

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
080636AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network Past Accepting new patients
Obstetrix Medical Group of Arizona, P.C. Advanced Practice Midwife Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1306808670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30280",
            "address_2": "OBSTETRIX MEDICAL GROUP OF AZ, P.C.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857510280",
            "telephone_number": "520-881-3936",
            "fax_number": "520-795-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "address_2": "OBSTETRIX MEDICAL GROUP OF AZ, P.C.",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122805",
            "telephone_number": "520-881-3936",
            "fax_number": "520-795-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSTALEK",
        "first_name": "PATRICIA",
        "middle_name": "SUZANNE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "080636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157924",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "080636",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN RECOGNITION",
            "identifier": "166",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE MIDWIFE CERTIFICATE",
            "identifier": "102",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "216287",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP CERTIFICATE",
            "identifier": "00145",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "40189",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.

Verify at the official NPI Registry.