Individual provider Active NPI

Maria Luisa Jabido

  • Nurse Practitioner
  • Minnetoka, MN
National Provider Identifier
1699208736
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60853275 Issued in WA
Practice address
9900 Bren Road East
Minnetoka, MN 55343
Phone
(206) 561-5235
NPI assigned
Apr 5, 2017
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.015836 IL
Nurse Practitioner 363L00000X AP60853275 WA Primary

Addresses

Primary practice location

9900 Bren Road East
Minnetoka, MN 55343

Mailing address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200313000704 WA Practitioner - Nurse Practitioner 7810273307 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.015836ILMDNurse Practitioner
AP60853275WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current Accepting new patients
Optum Care Washington PLLC CurrentSince Mar 16, 2020 Accepting new patients
Vpa PC CurrentSince Apr 26, 2021 Accepting new patients
Vpa PC CurrentSince Apr 26, 2021 Accepting new patients
Optum Care Washington PLLC CurrentSince Mar 16, 2020 Accepting new patients
Humboldt Park Health Past Accepting new patients

Locations

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

8910 Vernon Rd
Lake Stevens, WA 98258
Phone (425) 397-1700

606 Oakesdale Ave SW
Ste C200
Renton, WA 98057
Phone (866) 259-1629

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Organizations & group practices 6

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1699208736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN ROAD EAST",
            "city": "MINNETOKA",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "206-561-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABIDO",
        "first_name": "MARIA LUISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.015836",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60853275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.