Individual provider Active NPI

Miriam Mona Gaffer Ferreira, PA-C

  • Medical Physician Assistant
  • Berkeley, CA
National Provider Identifier
1013230440
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20883 Issued in CA
Practice address
2828 Telegraph Ave
Berkeley, CA 94705-1119
Phone
(510) 848-8404
Fax
(510) 848-6312
NPI assigned
Mar 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20883 CA Primary

Addresses

Primary practice location

2828 Telegraph Ave
Berkeley, CA 94705-1119

Mailing address

28094 Petrina CT
Hayward, CA 94545-4968
Phone (510) 783-5978

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110314000376 CA Practitioner - Physician Assistant 1052593985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.71 of 100Reported as group
Quality
61.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20883CAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mferreira190913@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1013230440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28094 PETRINA CT",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945454968",
            "telephone_number": "510-783-5978",
            "fax_number": "510-783-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051119",
            "telephone_number": "510-848-8404",
            "fax_number": "510-848-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAFFER FERREIRA",
        "first_name": "MIRIAM",
        "middle_name": "MONA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.