Active NPI
Rima Datunarachchi, MD
- Student in an Organized Health Care Education/Training Program
- Milwaukee, WI
National Provider Identifier
1992445647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1121 E North Ave
Milwaukee, WI 53212-3515 - Phone
- (414) 267-6502
- NPI assigned
- Mar 30, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1121 E North Ave
Milwaukee, WI 53212-3515
Mailing address
1121 E North Ave
Milwaukee, WI 53212-3515
Other names 1
- Rima Minazetdinova
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Contra Costa County | Current | Accepting new patients | |
| Contra Costa County | Current | Accepting new patients |
Locations
2500 Alhambra Ave
Martinez, CA 94553
Phone (925) 370-5000
2523 El Portal Dr
Ste 206
San Pablo, CA 94806
Phone (510) 215-3730
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.
-
- Adult Mental Health Clinic/Center
- San Pablo, CA
- NPI 1376620336
-
- General Acute Care Hospital
- Martinez, CA
- NPI 1386719086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648598400000",
"number": "1992445647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1121 E NORTH AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532123515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 E NORTH AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532123515",
"telephone_number": "414-267-6502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DATUNARACHCHI",
"first_name": "RIMA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-30",
"last_updated": "2022-03-30",
"certification_date": "2022-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RIMA",
"last_name": "MINAZETDINOVA",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.