Nancy Altamirano, MD

Individual provider Active NPI Pediatrics Physician · Coos Bay, OR

NPI 1932159159 · NPPES record last updated Aug 6, 2019

Key facts

NPI
1932159159
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
MD190330 (OR)
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone
(541) 267-5151
Fax
(541) 266-4566
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare Care Compare profile

Specialty
Pediatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Bend Medical Center Inc (92 clinicians)

Practice addresses (Care Compare)

1900 Woodland Dr
Coos Bay, OR 97420-2045
Phone (541) 267-5151

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190412001657 OR Practitioner - Pediatric Medicine 0143532499 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Medical Center Inc Current
since May 1, 2019
Accepting new patients
Virginia Pediatrics PC Pediatrics Past Accepting new patients
North Bend Medical Center Inc Past Accepting new patients

Locations

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6906/brand/1/csg/1/fhir/r4
  • Direct secure messaging: naltamirano124229@secure.stcharleshealthcare.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101056004 VA
Pediatrics Physician 208000000X MD190330 OR Yes

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-2099

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone (541) 267-5151

Other identifiers

IdentifierTypeStateIssuer
C09463OtherVAGROUP PTAN
500759702MedicaidOR

Other names

  • Nancy Fajardo McQuilkin Former name

Other providers in Coos Bay, OR

All providers in Coos Bay, OR · Pediatrics Physician in Oregon

Sources for this page

Verify at the official NPI Registry.