Individual provider Active NPI

Bibiana Restrepo, MD

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1992992887
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME102030 Issued in FL
Practice address
800 Washington St
# 334
Boston, MA 02111-1552
Phone
(617) 636-8080
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 258857 MA
Developmental - Behavioral Pediatrics Physician 2080P0006X 151456 CA
General Practice Physician 208D00000X BP10021650 TX
General Practice Physician 208D00000X ME102030 FL
Pediatrics Physician 208000000X ME102030 FL Primary

Addresses

Primary practice location

800 Washington St
# 334
Boston, MA 02111-1552

Mailing address

2825 50TH St
Sacramento, CA 95817-2310
Phone (916) 703-0300

Other identifiers 1

IdentifierTypeStateIssuer
000315000MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004002739 CA Practitioner - Pediatric MedicinePractitioner - Other (Physician) 3870715071 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
258857MAMDDevelopmental - Behavioral Pediatrics Physician
ME102030FLMDGeneral Practice Physician
BP10021650TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Ca Pediatrics CurrentSince Aug 29, 2017 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 29, 2017 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2825 50th St
Sacramento, CA 95817
Phone (916) 703-0300

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1992992887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 50TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172310",
            "telephone_number": "916-703-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "# 334",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTREPO",
        "first_name": "BIBIANA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "MA",
            "license": "258857",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "151456",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "BP10021650",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME102030",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME102030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000315000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.