Individual provider Active NPI

Gwynne L Searls, PA

  • Medical Physician Assistant
  • Orinda, CA
National Provider Identifier
1023154234
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10704 Issued in CA
Practice address
140 Brookwood Rd
Suite 201
Orinda, CA 94563-3042
Phone
(925) 254-9090
Fax
(925) 254-4399
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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 PA10704 CA Primary

Addresses

Primary practice location

140 Brookwood Rd
Suite 201
Orinda, CA 94563-3042

Mailing address

Dept 34929
P.O. Box 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828

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
I20140804000821 CA Practitioner - Physician Assistant 5193942803 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10704CAMDAudiologist
PA10704CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Oct 23, 2012 Accepting new patients

Locations

3260 Sacramento St
Berkeley, CA 94702
Phone (510) 428-4500

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Organizations & group practices 2

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1023154234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34929",
            "address_2": "P.O. BOX 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "925-952-2828",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BROOKWOOD RD",
            "address_2": "SUITE 201",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945633042",
            "telephone_number": "925-254-9090",
            "fax_number": "925-254-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARLS",
        "first_name": "GWYNNE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA10704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

Sources for this page

Verify at the official NPI Registry.