Individual provider Active NPI

Haley Elise Weiner

  • Physician Assistant
  • Watsonville, CA
National Provider Identifier
1134829211
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
62860 Issued in CA
Practice address
75 Nielson St
Watsonville, CA 95076-2468
Phone
(831) 724-4741
NPI assigned
Mar 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 363AM0700X CA
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 62860 CA Primary

Addresses

Primary practice location

75 Nielson St
Watsonville, CA 95076-2468

Mailing address

822 Nevada Ave
San Jose, CA 95125-2432
Phone (408) 838-8744

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
I20230809001495 CA Practitioner - Physician Assistant 4183086085 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pleasanton Emergency Medical GroupGroup PAC ID 0143118927, 38 clinicians

Practice addresses (Care Compare)

1111 E Stanley Blvd
Livermore, CA 94550-4115
Phone (925) 373-4018

1133 E Stanley Blvd
Livermore, CA 94550-4200
Phone (925) 373-4500

4000 Dublin Blvd
Suite 150
Dublin, CA 94568-3180
Phone (925) 479-3773

5555 W Las Positas Blvd
Pleasanton, CA 94588-4000
Phone (925) 416-3418

Hospital & facility affiliations

  • Stanford Health Care Tri-Valley Hospital, Pleasanton, CA, CCN 050283

Merit-based Incentive Payment System (MIPS)

Final score
82.7 of 100Reported as group
Quality
57.11
Promoting interoperability
100
Improvement activities
40
Cost
73.85

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62860CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
363AM0700XCAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Aug 14, 2023 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Aug 14, 2023 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Organizations & group practices 5

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 1

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": "1678147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1134829211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 NEVADA AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951252432",
            "telephone_number": "408-838-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NIELSON ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762468",
            "telephone_number": "831-724-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "HALEY",
        "middle_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "363AM0700X",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.