Individual provider Active NPI

Ma Mildred Bebero, FNP

  • Primary Care Nurse Practitioner
  • Merced, CA
National Provider Identifier
1841757598
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95010918 Issued in CA
Practice address
315 E 13TH St
Merced, CA 95341-6211
Phone
(209) 564-4500
NPI assigned
Feb 28, 2019
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95010918 CA Primary

Addresses

Primary practice location

315 E 13TH St
Merced, CA 95341-6211

Mailing address

410 E Yosemite Ave
Ste a
Merced, CA 95340-8220
Phone (209) 384-9108

Other names 1

  • Mildred Bebero Other 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
I20211118002431 CA Practitioner - Nurse Practitioner 7315367836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Provident Primary Care IncGroup PAC ID 8628350873, 10 clinicians

Practice addresses (Care Compare)

410 E Yosemite Ave
Suite a
Merced, CA 95340-8220
Phone (209) 384-9108

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95010918CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provident Primary Care Inc Primary Care CurrentSince Nov 10, 2021 Accepting new patients
Sunit R Patel MD a Professional Corporation Past Accepting new patients

Locations

3349 G St
Ste C
Merced, CA 95340
Phone (209) 384-4400

410 E Yosemite Ave
Ste A
Merced, CA 95340
Phone (209) 384-9108

450 E Yosemite Ave
Ste A
Merced, CA 95340
Phone (209) 723-4885

Interoperability endpoints

  • Direct secure messaging: mamildredbebero@mcpmedicalofc.directglo.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1841757598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E YOSEMITE AVE",
            "address_2": "STE A",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408220",
            "telephone_number": "209-384-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E 13TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416211",
            "telephone_number": "209-564-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEBERO",
        "first_name": "MA MILDRED",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95010918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILDRED",
            "last_name": "BEBERO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.