Iracema Arevalo, M.D

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

35089621 Issued in OH

Practice address

715 S Taft Ave
Fremont, OH 43420-3200

Phone

(419) 334-6679

Fax

(419) 334-6690

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iarevalo21124@direct.promedica.org

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.

• Memorial Professional Services LTD

  • Pulmonary Disease Physician
  • Fremont, OH
  • NPI 1205139623

  OH, Pediatric Infectious Diseases

  Medicare reassignment NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Memorial Hospital

  • General Acute Care Hospital
  • Fremont, OH
  • NPI 1851338149
  NPD (past)

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428969600000",
    "number": "1962620294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FOX RUN DR",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434208562",
            "telephone_number": "567-201-2213",
            "fax_number": "419-334-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S TAFT AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203200",
            "telephone_number": "419-334-6679",
            "fax_number": "419-334-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AREVALO",
        "first_name": "IRACEMA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2015-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "OH",
            "license": "35089621",
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "OH",
            "license": "35. 089621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Amor, BSN, RN, LSN
• Paul Anderson
• Courtney Andryc, OTD, OTR/L
• Angie'S Spa, LLC
• Ramsha Aqeel, MD
• Kriti Arora, M.D.
• Muhamid Asif, ND
• Assisted Living Concepts Inc
• Danielle D Atkins, STNA
• Melissa Avery

• All providers in Fremont, OH
• Pediatric Infectious Diseases Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.