Individual provider Active NPI

Virginia Anne Mara, FNP-BC

  • Family Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1548735715
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010219 Issued in CA
Practice address
2441 W la Palma Ave Ste 100
Anaheim, CA 92801-2658
Phone
(657) 282-6356
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95029055 CA
Family Nurse Practitioner 363LF0000X 95010219 CA Primary

Addresses

Primary practice location

2441 W la Palma Ave Ste 100
Anaheim, CA 92801-2658

Mailing address

2441 W la Palma Ave Ste 100
Anaheim, CA 92801-2658
Phone (657) 282-6356

Other names 1

  • Virginia Anne Lopez Former name

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
I20190125001680 CA Practitioner - Nurse Practitioner 9234476425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of California IrvineGroup PAC ID 5395658181, 57 clinicians

Practice addresses (Care Compare)

2441 W la Palma Ave
Anaheim, CA 92801-2658
Phone (657) 282-6356

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95029055CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine CurrentSince Oct 11, 2021 Accepting new patients
Regents of the University of CurrentSince Oct 11, 2021 Accepting new patients
University of California Irvine CurrentSince Oct 11, 2021 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

300 W Carl Karcher Way
Anaheim, CA 92801
Phone (657) 282-6356

2441 W La Palma Ave
Ste 100
Anaheim, CA 92801
Phone (657) 282-6356

200 S Manchester Ave
Ste 300
Orange, CA 92868
Phone (714) 424-9001

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

800 N Main St
Santa Ana, CA 92701
Phone (714) 456-6324

Interoperability endpoints

  • Direct secure messaging: vlopez1374359@oc.providencedirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1548735715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 W LA PALMA AVE STE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012658",
            "telephone_number": "657-282-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 W LA PALMA AVE STE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012658",
            "telephone_number": "657-282-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARA",
        "first_name": "VIRGINIA",
        "middle_name": "ANNE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95029055",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "LOPEZ",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.