NPIMap

Individual provider Active NPI

Sheila Marie Duarte, D.D.S.

  • General Practice Dentistry
  • Onawa, IA
National Provider Identifier
1972678696
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
07748 Issued in IA
Practice address
909 Iowa Ave
Onawa, IA 51040-1631
Phone
(712) 433-3937
Fax
(712) 433-1493
NPI assigned
Nov 21, 2006
Last updated
Mar 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 07748 IA Primary

Addresses

Primary practice location

909 Iowa Ave
Onawa, IA 51040-1631

Mailing address

909 Iowa Ave
PO Box 28
Onawa, IA 51040-1631
Phone (712) 433-3937

Other identifiers 3

IdentifierTypeStateIssuer
1116020MedicaidIA
1305152OtherIAUNITED CONCORDIA
51891OtherIAWELLMARK

Other names 1

  • Mrs. Sheila Marie Duarte Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20150715000002 IA Order and Referring Only - DentistPractitioner - Dentist 2062631898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07748IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Duarte & Gelinne, D.D.S., P.C. General Practice Past Accepting new patients
Family First Dental Associates of Primghar, P.C. General Practice PastSince Sep 22, 2015 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Burgess Health CenterOnawa, IA, CCN 161359 Hospital Corporate Director Jan 27, 2014
Burgess Health CenterOnawa, IA, CCN 16Z359 Hospital Corporate Director Jan 27, 2014
Burgess Home HealthOnawa, IA, CCN 167146 Home health agency Corporate Director Jan 27, 2014
Burgess HospiceOnawa, IA, CCN 161539 Hospice Corporate Director Jan 27, 2014
Burgess Family Clinic - Maple ValleyMapleton, IA, CCN 168538 Rural health clinic Corporate Director Jan 27, 2014
Burgess Family Clinic - SloanSloan, IA, CCN 163483 Rural health clinic Corporate Director Jan 27, 2014

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1972678696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 IOWA AVE",
            "address_2": "PO BOX 28",
            "city": "ONAWA",
            "state": "IA",
            "postal_code": "510401631",
            "telephone_number": "712-433-3937",
            "fax_number": "712-433-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 IOWA AVE",
            "city": "ONAWA",
            "state": "IA",
            "postal_code": "510401631",
            "telephone_number": "712-433-3937",
            "fax_number": "712-433-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUARTE",
        "first_name": "SHEILA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "07748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116020",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1305152",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "51891",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHEILA",
            "last_name": "DUARTE",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Onawa, IA

Sources for this page

Verify at the official NPI Registry.