Organization Active NPI

New Life OBGYN PLLC

  • Obstetrics & Gynecology Physician
  • Yakima, WA
National Provider Identifier
1558022103
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NEW LIFE OBGYN PLLC
Practice address
1006 S 64TH Ave Ste 120
Yakima, WA 98908-2090
Phone
(509) 517-7777
Fax
(509) 317-9547
NPI assigned
Jan 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Dr. Rachelle Sanjuan Chavez, DONPI 1811422025
Title
Owner
Phone
(509) 517-5777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1006 S 64TH Ave Ste 120
Yakima, WA 98908-2090

Mailing address

1006 S 64TH Ave Ste 120
Yakima, WA 98908-2090
Phone (509) 517-5777

Other names 1

  • New Life Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220628001880 WA Part B Supplier - Clinic/Group Practice 7517346166 Receives reassigned benefits from 2 practitioners
Practice locations: Yakima, WA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2265708New Life Clinic1006 S 64TH Ave Ste 120, Yakima, WA 98908Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory

Locations

1006 S 64th Ave
Ste 120
Yakima, WA 98908
Phone (509) 517-5777

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1558022103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 S 64TH AVE STE 120",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082090",
            "telephone_number": "509-517-5777",
            "fax_number": "509-317-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S 64TH AVE STE 120",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082090",
            "telephone_number": "509-517-7777",
            "fax_number": "509-317-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE OBGYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-05",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "SANJUAN CHAVEZ",
        "authorized_official_first_name": "RACHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-517-5777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Life Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Life Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.