Pedro Olap Atienza, M.D. – Surgery Physician

Key facts

NPI: 1912977620
Entity type: Individual (NPI type 1)
Primary specialty: Surgery Physician 208600000X
License: 19214 (IA)
Practice address: 611 W Quarry St
Maquoketa, IA 52060-2125
Phone: (563) 652-5145
Fax: (563) 652-3674
NPI assigned: Jan 25, 2006
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Hospice of Jackson County,Inc Community Based Hospice Care Agency · Maquoketa, IA · NPI 1609873769

NPD (past)
Medical Associates of Maquoketa PC Family Medicine Physician · Preston, IA · NPI 1629350814

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Hospice of Jackson County,Inc		Past	Accepting new patients
Medical Associates of Maquoketa PC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Surgery Physician	208600000X	19214	IA	Yes

Addresses

Primary practice location

611 W Quarry St
Maquoketa, IA 52060-2125

Mailing address

611 W Quarry St
Maquoketa, IA 52060-2125
Phone (563) 652-5145

Other identifiers

Identifier	Type	State	Issuer
204586	Other	IA	BCBS - NOT OFFICE I.D.
1204586	Medicaid	IA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 7, 2023.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912977620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W QUARRY ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602125",
            "telephone_number": "563-652-5145",
            "fax_number": "563-652-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W QUARRY ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602125",
            "telephone_number": "563-652-5145",
            "fax_number": "563-652-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIENZA",
        "first_name": "PEDRO",
        "middle_name": "OLAP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "19214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - NOT OFFICE I.D.",
            "identifier": "204586",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1204586",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maquoketa, IA

All providers in Maquoketa, IA · Surgery Physician in Iowa

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.