Maria Katherine Reesink

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA59802 Issued in CA

Practice address

1641 Creekside Dr Ste 201
Folsom, CA 95630-3831

Phone

(916) 983-3069

NPI assigned

Apr 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maria Katherine Shafer Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542

  CA

  Medicare reassignment
• Joanna H Nguyen MD Inc

  • Family Medicine Physician
  • Folsom, CA
  • NPI 1558516070

  CA

  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Davis, CA
  • NPI 1326346438
  NPD

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1003445016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 CREEKSIDE DR STE 201",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303831",
            "telephone_number": "661-972-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 CREEKSIDE DR STE 201",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303831",
            "telephone_number": "916-983-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESINK",
        "first_name": "MARIA",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "SHAFER",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bhavani Ravulapalli, LCSW
• Martina Dominique Reburiano
• Recovery & Resilience Centers
• Redwood Senior Care
• Sara Reed, FNP-C
• Reeves, D.D.S. and Lavalley, D.D.S., a Dental Corporation
• Jill Reeves, PHARM D
• Jessie Regan, LMFT
• Regency Eye Care, Inc.
• Regents of the University of California

• All providers in Folsom, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.

Verify at the official NPI Registry.