Individual provider Active NPI

Angelique Ferrer Varela, MD

  • Obstetrics & Gynecology Physician
  • Flagstaff, AZ
National Provider Identifier
1508830696
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
22546 Issued in AZ
Practice address
3801 N Paradise Rd
Flagstaff, AZ 86004-1610
Phone
(928) 607-0323
Fax
(928) 526-5763
NPI assigned
Feb 15, 2006
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 22546 AZ Primary

Addresses

Primary practice location

3801 N Paradise Rd
Flagstaff, AZ 86004-1610

Mailing address

3801 N Paradise Rd
Flagstaff, AZ 86004-1610
Phone (928) 607-0323

Other identifiers 1

IdentifierTypeStateIssuer
168783004MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161229001135 AZ Practitioner - Obstetrics/Gynecology 3779536578 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22546AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Vista Regional Health Center Medical Group LLC Family Medicine CurrentSince Nov 12, 2016 Accepting new patients
RCHP-Sierra Vista Inc PastSince Nov 12, 2016 Accepting new patients
Banner Estrella Medical Center Past Accepting new patients
Honorhealth Past Accepting new patients

Locations

151 Colonia de Salud
Ste B
Sierra Vista, AZ 85635
Phone (520) 263-3835

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

5750 E Highway 90
Ste 150
Sierra Vista, AZ 85635
Phone (520) 263-3500

Organizations & group practices 5

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1508830696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N PARADISE RD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041610",
            "telephone_number": "928-607-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N PARADISE RD",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041610",
            "telephone_number": "928-607-0323",
            "fax_number": "928-526-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARELA",
        "first_name": "ANGELIQUE",
        "middle_name": "FERRER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "22546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168783004",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.