VIVIAN ROSE PAULEY MD
NPI 1417417460
Student in an Organized Health Care Education/Training Program in Sacramento, CA

Q: What is Vivian Pauley's NPI number?

The NPI number for Vivian Pauley is 1417417460. It was assigned to this individual provider in the NPPES registry on March 24, 2019.

Q: What is Vivian Pauley's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Vivian Pauley was last updated on October 31, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 24, 2019PECOS Enrolled

6600 BRUCEVILLE RD, SACRAMENTO, CA 95823(916) 688-2417 Get Directions Write a Review

NPPES record last updated: October 31, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 31, 2022, Mar 24, 2019 (2 updates tracked since 2019).

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About Vivian Rose Pauley Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIVIAN ROSE PAULEY MD (NPI 1417417460) is an individual student in an organized health care education/training program in Sacramento, California and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Burlington.

NPPES Registry Identity

NPI1417417460

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameVIVIAN ROSE PAULEYCredential: MD

Location Address6600 BRUCEVILLE RDSacramento, CA 95823-4671

Mailing Address6600 Bruceville RdSacramento, CA 95823-4671 · (916) 688-2417

Phone(916) 688-2417

Sole ProprietorNo

Enumeration DateMarch 24, 2019

Last NPPES UpdateOctober 31, 20222 updates tracked since enumeration

NPPES CertifiedMay 16, 2022

✔ NPI 1417417460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6600 BRUCEVILLE RD, Sacramento, CA 95823

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Secondary Practice Location 1

Location 1111 Colchester AveBurlington, VT 05401-1473 · Phone (802) 847-2345

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vivian Rose Pauley Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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