Marie J Reedy, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1073128 Issued in CA

Practice address

1980 Broadway
Placerville, CA 95667-9001

Phone

(530) 622-3536

Fax

(530) 622-3538

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marie J Olson Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Northbay Health Medical Foundation

  • Internal Medicine Physician
  • Fairfield, CA
  • NPI 1760283527
  Medicare reassignment NPD
• Premier Healthcare of Placerville

  • Pain Medicine Physician
  • Placerville, CA
  • NPI 1932345410
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1114022233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 BROADWAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956679001",
            "telephone_number": "530-622-3536",
            "fax_number": "530-622-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 BROADWAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956679001",
            "telephone_number": "530-622-3536",
            "fax_number": "530-622-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDY",
        "first_name": "MARIE",
        "middle_name": "J",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1073128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "OLSON",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angelica R Randle
• Danny George Raviart, SUDCC
• Margaret M Ray, MFTI
• Tyler Jerome Redmond
• Mark W Redor, M.D.
• Amy Catherine Reese, PHARMD
• Stephanie Reese
• Sudhakar Rendla, M.D
• William George Reust
• Deena Lee Reyes

• Physician Assistant in Placerville, CA
• Providers in Placerville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.