Individual provider Active NPI

Ando Muneno, PA-C

  • Physician Assistant
  • Redding, CA
National Provider Identifier
1164977005
Registry record updated Nov 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56655 Issued in CA
Practice address
415 Knollcrest Dr Ste 101
Redding, CA 96002-0181
Phone
(530) 392-4399
NPI assigned
Aug 21, 2016
Last updated
Nov 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 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 56655 CA Primary

Addresses

Primary practice location

415 Knollcrest Dr Ste 101
Redding, CA 96002-0181

Mailing address

415 Knollcrest Dr Ste 101
Redding, CA 96002-0181
Phone (530) 392-4399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170223000004 VA Practitioner - Physician Assistant 8022392851 Reassigns benefits to 1 organization
I20190916003081 CA Practitioner - Physician Assistant 8022392851 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56655CAMDDentist
0110-005499VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jan 1, 2017 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jan 1, 2017 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 23, 2017 Accepting new patients
Hooman M. Javanmardi, Physical Therapist, a Professional Corporation PastSince Mar 5, 2018 Accepting new patients
Centers for Advanced Orthopaedics, LLC Past Accepting new patients

Locations

3414 Olandwood Ct
Olney, MD 20832
Phone (301) 774-0500

1515 Chain Bridge Rd
Ste 202
McLean, VA 22101
Phone (703) 490-1112

14605 Potomac Branch Dr
Ste 300
Woodbridge, VA 22191
Phone (703) 490-1112

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2241/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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": "1471737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793923200000",
    "number": "1164977005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 KNOLLCREST DR STE 101",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020181",
            "telephone_number": "530-392-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 KNOLLCREST DR STE 101",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020181",
            "telephone_number": "530-392-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNENO",
        "first_name": "ANDO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-21",
        "last_updated": "2026-11-06",
        "certification_date": "2026-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.