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ARLENE VERGARA
NPI 1528832276
Nurse Practitioner - Psychiatric/Mental Health in Martinsburg, WV

Active since November 13, 2023PECOS EnrolledAccepts Medicare Assignment
99 TAVERN RD, MARTINSBURG, WV 25401(304) 263-4999 Get Directions Write a Review

NPPES record last updated: February 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Arlene Vergara NPPES

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

ARLENE VERGARA (NPI 1528832276) is an individual psychiatric/mental health provider in Martinsburg, West Virginia, licensed in West Virginia (118367) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1528832276
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameARLENE VERGARA
Location Address99 TAVERN RDMartinsburg, WV 25401-2890
Mailing AddressPo Box 60Fairplay, MD 21733-0060 · (202) 670-7317
Phone(304) 263-4999
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateNovember 13, 2023
Last NPPES UpdateFebruary 21, 2024
NPPES CertifiedFebruary 21, 2024
✔ NPI 1528832276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in WV · 118367
Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License R199695 (MD)
99 TAVERN RD, Martinsburg, WV 25401
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Arlene Vergara is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507201126
PECOS Enrollment IDI20240305001363
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.

Medicare Billing Reassignment

Medicare enrollment records show Arlene Vergara reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shenandoah Valley Medical System, Inc.
Same address
Federally Qualified Health Center (FQHC)
99 TAVERN RD
Martinsburg, WV 25401
  • Reassigned Medicare billing, West Virginia enrollment
  • 33 clinicians in this Medicare group
NPI 1083617823 (304) 263-4999

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSIE ANN MCNAMEE
Nurse Practitioner (Family)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
SHENANDOAH VALLEY MEDICAL SYSTEM, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
GIANLUCA LAMONACA M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-7023
PRISCILLA BRYANT-SCHOENLY MSW
Social Worker (Clinical)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (302) 263-4999
KAREN ELIZABETH LAAKANIEMI MSN,CNM
Midwife
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 264-0660
KRISTA HOPKINS M.D.
Obstetrics & Gynecology
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
MRS. MICHELE M SHEETZ FNP
Nurse Practitioner (Family)
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999
LINDA GILLET CNM
Midwife
99 TAVERN RD
MARTINSBURG, WV 25401
Berkeley County (304) 263-4999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Arlene Vergara's NPI number?

The NPI number for Arlene Vergara is 1528832276. It was assigned to this individual provider in the NPPES registry on November 13, 2023.

Where is Arlene Vergara located?

Arlene Vergara practices at 99 Tavern Rd, Martinsburg, WV 25401. The listed phone number is (304) 263-4999.

What is Arlene Vergara's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Arlene Vergara enrolled in Medicare?

Yes. Arlene Vergara is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Arlene Vergara's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Arlene Vergara reassigns Medicare benefits to Shenandoah Valley Medical System, Inc. (Martinsburg, WV). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Arlene Vergara's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Arlene Vergara accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list Arlene Vergara as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Arlene Vergara was last updated on February 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.