Individual provider Active NPI

Theresa Schmitz, P.A.

  • Medical Physician Assistant
  • Hidden Valley Lake, CA
National Provider Identifier
1205928579
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14762 Issued in CA
Practice address
18990 Coyote Valley Rd Ste 10
Hidden Valley Lake, CA 95467-8339
Phone
(707) 987-8344
Fax
(707) 987-8395
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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 PA14762 CA Primary

Addresses

Primary practice location

18990 Coyote Valley Rd Ste 10
Hidden Valley Lake, CA 95467-8339

Mailing address

18990 Coyote Valley Rd Ste 10
Hidden Valley Lake, CA 95467-8339
Phone (707) 987-8344

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
I20130905000193 CA Practitioner - Physician Assistant 4486897709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1000 Trancas St
Napa, CA 94558-2906
Phone (707) 252-4411

1100 Trancas St
Napa, CA 94558-2909

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

Hospital & facility affiliations

  • Providence Queen of the Valley Medical Center Hospital, Napa, CA, CCN 050009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14762CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Sep 1, 2023 Accepting new patients
Providence Medical Foundation CurrentSince Sep 1, 2023 Accepting new patients
Adventist Health Clearlake Hospital Inc. Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

1100 Trancas St
Ste 209
Napa, CA 94558
Phone (707) 251-1850

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1205928579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18990 COYOTE VALLEY RD STE 10",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678339",
            "telephone_number": "707-987-8344",
            "fax_number": "707-984-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18990 COYOTE VALLEY RD STE 10",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678339",
            "telephone_number": "707-987-8344",
            "fax_number": "707-987-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITZ",
        "first_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hidden Valley Lake, CA

Sources for this page

Verify at the official NPI Registry.