Individual provider Active NPI

Caitlin Sarah Reid, P.A

  • Physician Assistant
  • Fremont, CA
National Provider Identifier
1205566841
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61410 Issued in CA
Practice address
39350 Civic Center Dr #300
Fremont, CA 94538
Phone
(510) 797-3933
Fax
(510) 975-5184
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 61410 CA Primary

Addresses

Primary practice location

39350 Civic Center Dr #300
Fremont, CA 94538

Mailing address

39350 Civic Center Dr #300
Fremont, CA 94538
Phone (510) 797-3933

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
I20230418001535 CA Practitioner - Physician Assistant 8729453030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Peak Orthopaedic Medical Group IncGroup PAC ID 9739165705, 15 clinicians

Practice addresses (Care Compare)

27206 Calaroga Ave
Suite 107
Hayward, CA 94545-4300
Phone (510) 300-9898

39350 Civic Ctr Dr
Fremont, CA 94538-2331
Phone (510) 797-3933

Hospital & facility affiliations

  • Trulife Home Health Care Home health agency, Hayward, CA, CCN 757432
  • St Rose Hospital Hospital, Hayward, CA, CCN 050002

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
86.58
Improvement activities
40
Cost
87.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61410CAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: creid138561@hpmg.direct-ci.net

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 2

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1205566841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR #300",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-797-3933",
            "fax_number": "510-975-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR #300",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-797-3933",
            "fax_number": "510-975-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "CAITLIN",
        "middle_name": "SARAH",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.