Caroline Jo Dimatteo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54955 Issued in CA

Practice address

901 W Civic Center Clinic
Ste 120
Santa Ana, CA 92703

Phone

(714) 835-8501

NPI assigned

Apr 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Caroline Jo Mucho Former name

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michael Decker DO, Inc.Group PAC ID 9830481746, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Michael Decker, DO, Inc

  • Skilled Nursing Facility
  • Hermosa Beach, CA
  • NPI 1528410842
  Medicare reassignment Care Compare group
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD

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

{
    "created_epoch": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1174058978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W CIVIC CENTER DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032352",
            "telephone_number": "714-835-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W CIVIC CENTER CLINIC",
            "address_2": "STE 120",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92703",
            "telephone_number": "714-835-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMATTEO",
        "first_name": "CAROLINE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-29",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "MUCHO",
            "middle_name": "JO",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alyssa Dilauro, PT, DPT
• Alison Dilbeck
• Dilshad Medical Inc
• Dima Summakia Professional Corporation
• John Joseph Dimare III
• Melinda Dimeo
• Dimitri Sirakoff D.O., Inc
• Dimitri Sirakoff DO Inc
• Dimitri Sirakoff, D.O., Inc.
• Dimitri Sirakoff, DO, Inc

• Physician Assistant in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.