Individual provider Active NPI

Mara Adelman, PHYSICIANS ASST PA

  • Physician Assistant
  • Fairfield, CA
National Provider Identifier
1124053483
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17260 Issued in CA
Practice address
470 Chadbourne Rd Ste a
Fairfield, CA 94534-9620
Phone
(866) 268-4489
NPI assigned
Jul 12, 2006
Last updated
Apr 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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 PA17260 CA Primary

Addresses

Primary practice location

470 Chadbourne Rd Ste a
Fairfield, CA 94534-9620

Mailing address

1141 Pear Tree LN
Napa, CA 94558-6484
Phone (707) 254-1770

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
I20040928000327 CA Practitioner - Physician Assistant 7810966785 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ole Health CurrentSince Aug 26, 2004 Accepting new patients
Ole Health CurrentSince Aug 26, 2004 Accepting new patients
Ole Health Past Accepting new patients

Locations

1327 Berry St
Calistoga, CA 94515
Phone (707) 254-1775

470 Chadbourne Rd
Ste A
Fairfield, CA 94534
Phone (707) 419-8989

1141 Pear Tree Ln
Ste 100
Napa, CA 94558
Phone (707) 254-1778

Interoperability endpoints

  • Direct secure messaging: madelman675429@direct.ochin.org

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1124053483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 PEAR TREE LN",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586484",
            "telephone_number": "707-254-1770",
            "fax_number": "707-254-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 CHADBOURNE RD STE A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349620",
            "telephone_number": "866-268-4489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELMAN",
        "first_name": "MARA",
        "name_prefix": "Ms.",
        "credential": "PHYSICIANS ASST PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.