NPIMap

Individual provider Active NPI

Soquel Schafer, PA-C

  • Adult Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1215442991
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
55193 Issued in CA
Practice address
84 Santa Rosa St
San Luis Obispo, CA 93405-1812
Phone
(805) 591-4727
NPI assigned
Dec 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 55193 CA Primary

Addresses

Primary practice location

84 Santa Rosa St
San Luis Obispo, CA 93405-1812

Mailing address

PO Box 13026
San Luis Obispo, CA 93406-3026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180306002152 CA Practitioner - Physician Assistant 7517228687 Reassigns benefits to 1 organization
I20220518002179 CO Practitioner - Physician Assistant 7517228687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1644 Medical Ctr PT
Suite 200
Colorado Springs, CO 80907-5765
Phone (719) 634-1994

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55193CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Urological Associates LLC CurrentSince Oct 15, 2024 Accepting new patients
Dermatologic Plastic Surgery Clinics of Ca Past Accepting new patients

Locations

1644 Medical Center Pt
Colorado Springs, CO 80907
Phone (717) 776-4712

1644 Medical Center Pt
Ste 200
Colorado Springs, CO 80907
Phone (719) 634-1994

6071 E Woodmen Rd
Ste 300
Colorado Springs, CO 80923
Phone (719) 531-7007

Organizations & group practices 3

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 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1215442991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13026",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934063026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 SANTA ROSA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051812",
            "telephone_number": "805-591-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "SOQUEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "55193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.