Individual provider Active NPI

Maria Lucia Niepagen, FNP

  • Family Nurse Practitioner
  • Bishop, CA
National Provider Identifier
1447718978
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011261 Issued in CA
Practice address
250 N See Vee LN
Bishop, CA 93514-8130
Phone
(760) 873-8461
Fax
(760) 873-3908
NPI assigned
Mar 4, 2019
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 95011261 CA Primary

Addresses

Primary practice location

250 N See Vee LN
Bishop, CA 93514-8130

Mailing address

250 N See Vee LN
Bishop, CA 93514-8130
Phone (760) 873-8461

Other practice location 1

2201 South Ave
South Lake Tahoe, CA 96150-7025
Phone (530) 543-5623

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
I20190423000724 CA Practitioner - Nurse Practitioner 8022350016 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95028660CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Carson Valley Medical Group Inc CurrentSince Oct 1, 2021 Accepting new patients

Locations

1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

2201 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5550

Interoperability endpoints

  • Direct secure messaging: lucia.niepagen.p1@direct.toiyabe.nextgenshare.com

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": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1447718978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SEE VEE LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148130",
            "telephone_number": "760-873-8461",
            "fax_number": "760-873-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N SEE VEE LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148130",
            "telephone_number": "760-873-8461",
            "fax_number": "760-873-3908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 South Ave",
            "address_purpose": "LOCATION",
            "city": "South Lake Tahoe",
            "state": "CA",
            "postal_code": "961507025",
            "country_code": "US",
            "telephone_number": "530-543-5623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEPAGEN",
        "first_name": "MARIA",
        "middle_name": "LUCIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

Verify at the official NPI Registry.