Active NPI
Patricia Suzanne Dostalek, CNM
- Advanced Practice Midwife
- Tucson, AZ
National Provider Identifier
1306808670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 080636
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 157924 | Medicaid | AZ | |
| 080636 | Other | AZ | RN LICENSE |
| 166 | Other | HI | APRN RECOGNITION |
| 102 | Other | CA | NURSE MIDWIFE CERTIFICATE |
| 216287 | Other | CA | RN LICENSE |
| 00145 | Other | AZ | ARNP CERTIFICATE |
| 40189 | Other | HI | RN 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
| License | State | Type | Specialty |
|---|---|---|---|
| 080636 | AZ | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Maternal & Fetal Medicine Physician
- Tucson, AZ
- NPI 1316961022
Advanced Practice Midwife
-
- Multi-Specialty Clinic/Center
- Tucson, AZ
- NPI 1750832283
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.