NPIMap

Individual provider Active NPI

J'Nisha Jolani Aquino Manibusan, PA-C

  • Physician Assistant
  • Palo Alto, CA
National Provider Identifier
1043985856
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60280 Issued in CA
Practice address
590 Forest Ave
Palo Alto, CA 94301-2611
Phone
(888) 663-6331
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 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 PA60280 CA Primary

Addresses

Primary practice location

590 Forest Ave
Palo Alto, CA 94301-2611

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

785 Camino Del Sur Apt 301
Goleta, CA 93117-4470
Phone (803) 477-4245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209002822 CA Practitioner - Physician Assistant 4183014962 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Loma Linda University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

110 Sutter St
Suite 6
San Francisco, CA 94104-4020
Phone (888) 663-6331

2515 El Camino Real
Suite 201
Palo Alto, CA 94306-1776
Phone (888) 663-6331

590 Forest Ave
Palo Alto, CA 94301-2611
Phone (650) 288-4080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60280CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara Neighborhood Clinics CurrentSince Dec 6, 2021 Accepting new patients
One Medical Group, Inc CurrentSince Oct 7, 2024 Accepting new patients
One Medical Group, Inc. CurrentSince Oct 7, 2024 Accepting new patients

Locations

2515 El Camino Real
Ste 201
Palo Alto, CA 94306

590 Forest Ave
Palo Alto, CA 94301
Phone (650) 288-4080

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

414 E Cota St
Fl 1
Santa Barbara, CA 93101
Phone (805) 617-7863

628 W Micheltorena St
Santa Barbara, CA 93101
Phone (805) 963-1546

Organizations & group practices 4

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 7

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1043985856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FOREST AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012611",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "785 Camino Del Sur Apt 301",
            "address_purpose": "LOCATION",
            "city": "Goleta",
            "state": "CA",
            "postal_code": "931174470",
            "country_code": "US",
            "telephone_number": "803-477-4245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANIBUSAN",
        "first_name": "J'NISHA JOLANI",
        "middle_name": "AQUINO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.