Individual provider Active NPI

Olga Petlinska, PA-C

  • Medical Physician Assistant
  • Rancho Cordova, CA
National Provider Identifier
1164785671
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA22311 Issued in CA
Practice address
1995 Zinfandel Dr
Suite 201
Rancho Cordova, CA 95670-2862
Phone
(916) 852-6001
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA22311 CA Primary

Addresses

Primary practice location

1995 Zinfandel Dr
Suite 201
Rancho Cordova, CA 95670-2862

Mailing address

1995 Zinfandel Dr
Ste. 201
Rancho Cordova, CA 95670-2862
Phone (916) 852-6001

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
I20120725001051 CA Practitioner - Physician Assistant 9739345307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hemal Amin MD, IncGroup PAC ID 7618416124, 4 clinicians

Practice addresses (Care Compare)

1995 Zinfandel Dr
Suite 201
Rancho Cordova, CA 95670-2862
Phone (816) 852-6001

Hospital & facility affiliations

  • Your Choice Home Health, Inc Home health agency, Rancho Cordova, CA, CCN 053168
  • Alars Home Health, LLC Home health agency, Sacramento, CA, CCN 059609
  • Ahc Home Health of Sacramento Home health agency, Sacramento, CA, CCN 757092
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA22311CAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: opetlinska279669@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 5

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1164785671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 ZINFANDEL DR",
            "address_2": "STE. 201",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702862",
            "telephone_number": "916-852-6001",
            "fax_number": "916-852-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 ZINFANDEL DR",
            "address_2": "SUITE 201",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702862",
            "telephone_number": "916-852-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETLINSKA",
        "first_name": "OLGA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

Verify at the official NPI Registry.