Individual provider Active NPI

Teena Leya Kalapurayil, PA-C

  • Physician Assistant
  • Fair Oaks, CA
National Provider Identifier
1134940455
Registry record updated Oct 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65288 Issued in CA
Practice address
12417 Fair Oaks Blvd Ste 600
Fair Oaks, CA 95628-2500
Phone
(916) 727-1400
NPI assigned
Oct 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 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 PA65288 CA Primary

Addresses

Primary practice location

12417 Fair Oaks Blvd Ste 600
Fair Oaks, CA 95628-2500

Mailing address

12417 Fair Oaks Blvd Ste 600
Fair Oaks, CA 95628-2500
Phone (916) 727-1400

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
I20250124000720 CA Practitioner - Physician Assistant 7517496276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12417 Fair Oaks Blvd
Suite 600
Fair Oaks, CA 95628-2500
Phone (916) 727-1400

4345 Arden Way
Sacramento, CA 95864-3102
Phone (916) 727-1400

6651 Madison Ave
Carmichael, CA 95608-0602
Phone (916) 727-1400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA65288CAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1729296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1134940455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12417 FAIR OAKS BLVD STE 600",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282500",
            "telephone_number": "916-727-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12417 FAIR OAKS BLVD STE 600",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282500",
            "telephone_number": "916-727-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALAPURAYIL",
        "first_name": "TEENA",
        "middle_name": "LEYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-19",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

Verify at the official NPI Registry.