Individual provider Active NPI

Carmen Cabailo Briones, MD

  • Pediatrics Physician
  • Aberdeen, WA
National Provider Identifier
1700965753
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
52752 Issued in MN
Practice address
615 North F Street
Aberdeen, WA 98520
Phone
(360) 533-4599
Fax
(360) 537-6514
NPI assigned
Nov 2, 2006
Last updated
Jun 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 52752 MN Primary

Addresses

Primary practice location

615 North F Street
Aberdeen, WA 98520

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (218) 333-5000

Other practice location 1

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210623004026 CA Practitioner - Pediatric Medicine 6305033895 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecrest Regional Hospital CurrentSince May 1, 2021 Accepting new patients
Ridgecrest Regional Hospital CurrentSince May 1, 2021 Accepting new patients
Lancaster Hospital Corporation Past Accepting new patients
City of Wheaton Past Accepting new patients
Valley Children's Medical Group Pediatrics Past Accepting new patients
Sanford Bismarck Past Accepting new patients

Locations

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571

1111 N China Lake Blvd
#190
Ridgecrest, CA 93555
Phone (760) 499-3855

Interoperability endpoints

  • Direct secure messaging: carmenbriones@rrh.medalliesdirect.net

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1700965753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "218-333-5000",
            "fax_number": "218-333-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 NORTH F STREET",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "98520",
            "telephone_number": "360-533-4599",
            "fax_number": "360-537-6514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Anne St NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "56601",
            "country_code": "US",
            "telephone_number": "218-333-5000",
            "fax_number": "218-333-5360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIONES",
        "first_name": "CARMEN",
        "middle_name": "CABAILO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "52752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.