Prarthana Naren Mysore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

52524 Issued in CA

Practice address

2425 Stockton Blvd
Sacramento, CA 95817-2215

Phone

(916) 453-2000

NPI assigned

Aug 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Sacramento, CA
  • NPI 1679915565
  Medicare reassignment
• Shriners Hospitals for Children

  • Orthopaedic Surgery Physician
  • Philadelphia, PA
  • NPI 1275271462

  Physician Assistant

  NPD
• Shriners Hospitals for Children

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD
• George Wang,MD,LLC

  • Neurology Physician
  • Mesa, AZ
  • NPI 1184679201
  NPD (past)
• Shriners Hospitals for Children

  • Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1700223559
  NPD (past)

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1215129689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SHRINERS HOSPITALS FOR CHILDREN NORTHERN CALIFORNIA",
            "address_2": "2425 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-453-2000",
            "fax_number": "916-453-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172215",
            "telephone_number": "916-453-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSORE",
        "first_name": "PRARTHANA",
        "middle_name": "NAREN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3663",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BOARD OF CALIFORNIA",
            "identifier": "52524",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE LICENSE",
            "identifier": "3663",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariya P Myrmyr Sr.
• Yana Myrmyr, RN
• Sofya Myrmyrs, OFFICE ASSISTANT II
• Aira Mysaysana
• Purlang Mysaysana, MSW
• Demyd Myzga
• Maryam Nabavi, MS RD
• Iraj Nabi, M.D.
• Laura J Nabity
• Marigold Nabong-Verzosa, M.D.

• Physician Assistant in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.