Individual provider Active NPI

Ariele Anuva Andalon, PA-C

  • Physician Assistant
  • Oxnard, CA
National Provider Identifier
1043030067
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64936 Issued in CA
Practice address
1700 N Rose Ave Ste 320
Oxnard, CA 93030-7648
Phone
(805) 485-8709
NPI assigned
Oct 14, 2024
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 64936 CA Primary

Addresses

Primary practice location

1700 N Rose Ave Ste 320
Oxnard, CA 93030-7648

Mailing address

1906 Brush Oak CT
Newbury Park, CA 91320-5992
Phone (805) 559-1599

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
I20250324002811 CA Practitioner - Physician Assistant 4284156860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PMK Medical Group, Inc.Group PAC ID 9739127614, 7 clinicians

Practice addresses (Care Compare)

1700 N Rose Ave
Oxnard, CA 93030-7648

500 Paseo Camarillo
Suite 106
Camarillo, CA 93010-5900
Phone (805) 485-8709

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64936CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Cancer Care Inc. CurrentSince Oct 20, 2024 Accepting new patients

Locations

1700 N Rose Ave
Ste 320
Oxnard, CA 93030
Phone (805) 485-8709

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1043030067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 BRUSH OAK CT",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913205992",
            "telephone_number": "805-559-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N ROSE AVE STE 320",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930307648",
            "telephone_number": "805-485-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDALON",
        "first_name": "ARIELE",
        "middle_name": "ANUVA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.