Individual provider Active NPI

Lora Mina Rancourt, PA-C

  • Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1023388519
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22045 Issued in CA
Practice address
2625 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone
(925) 939-8585
NPI assigned
Dec 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22045 CA Primary

Addresses

Primary practice location

2625 Shadelands Dr
Walnut Creek, CA 94598-2512

Mailing address

PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585

Other practice location 1

3100 San Pablo Ave Ste 410
Berkeley, CA 94702-2498
Phone (925) 985-5000

Other identifiers 1

IdentifierTypeStateIssuer
PA22045OtherCASTATE LICENSE

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
I20130515000300 CA Practitioner - Physician Assistant 5597902379 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

2330 Post St
San Francisco, CA 94115-3465
Phone (415) 476-4029

3100 San Pablo Ave
Berkeley, CA 94702-2498
Phone (510) 985-5020

400 Parnassus Ave
San Francisco, CA 94143-2202

505 Parnassus Ave
San Francisco, CA 94143-2204
Phone (415) 476-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Mar 12, 2021 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Aug 6, 2018 Accepting new patients
University of California San Francisco CurrentSince Mar 12, 2021 Accepting new patients
UCSF Medical Group Business Services CurrentSince Mar 12, 2021 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

3100 San Pablo Ave
Ste 410
Berkeley, CA 94702
Phone (510) 985-5200

3100 San Pablo Ave
#410
Berkeley, CA 94702
Phone 5109855200 ext. 55261

350 John Muir Pkwy
Ste 155
Brentwood, CA 94513

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

1500 Owens St
Ste 300
San Francisco, CA 94158
Phone (415) 514-6234

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

5201 Norris Canyon Rd
Ste 230
San Ramon, CA 94583
Phone (925) 244-9355

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

2625 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 210-8500

Organizations & group practices 12

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1023388519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-939-8585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 San Pablo Ave Ste 410",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947022498",
            "country_code": "US",
            "telephone_number": "925-985-5000",
            "fax_number": "925-254-9802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANCOURT",
        "first_name": "LORA",
        "middle_name": "MINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA22045",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.