NPIMap

Individual provider Active NPI

Juliana Zamora Cubillos, MD

  • Family Medicine Physician
  • Lebanon, MO
National Provider Identifier
1952830127
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2020020191 Issued in MO
Practice address
120 Hospital Dr Ste 100
Lebanon, MO 65536-9227
Phone
(417) 533-6751
NPI assigned
Jun 9, 2017
Last updated
Jul 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10059397 TX
Family Medicine Physician 207Q00000X 2020020191 MO Primary

Addresses

Primary practice location

120 Hospital Dr Ste 100
Lebanon, MO 65536-9227

Mailing address

120 Hospital Dr Ste 100
Lebanon, MO 65536-9227
Phone (417) 533-6751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730002184 MO Practitioner - Family Practice 2668740689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

120 Hospital Dr
Suite 100
Lebanon, MO 65536-9227
Phone (417) 553-6751

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10059397TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jul 31, 2020 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jul 31, 2020 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jul 31, 2020 Accepting new patients

Locations

120 Hospital Dr
Ste 100
Lebanon, MO 65536
Phone (417) 533-6751

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: jzamoracubillos1057085@directc.mercy.net

Organizations & group practices 3

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1952830127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL DR STE 100",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369227",
            "telephone_number": "417-533-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL DR STE 100",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369227",
            "telephone_number": "417-533-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA CUBILLOS",
        "first_name": "JULIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10059397",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2020020191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, MO

Sources for this page

Verify at the official NPI Registry.