Individual provider Active NPI

Denise Amy West, PA-C

  • Physician Assistant
  • Encinitas, CA
National Provider Identifier
1235244302
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60061 Issued in CA
Practice address
700 Garden View CT Ste 100
Encinitas, CA 92024-2478
Phone
(760) 633-1000
Fax
(760) 753-8657
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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 1500805 KS
Physician Assistant 363A00000X 60061 CA Primary

Addresses

Primary practice location

700 Garden View CT Ste 100
Encinitas, CA 92024-2478

Mailing address

6399 San Ignacio Ave Ste 120
San Jose, CA 95119-1215
Phone (913) 424-4984

Other practice location 1

1934 Via Ctr Ste B
Vista, CA 92081-6056
Phone (760) 295-2299

Other identifiers 1

IdentifierTypeStateIssuer
100402570AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20231020000634 OK Practitioner - Physician Assistant 0244270833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, shared by 17 NPIs, 364 clinicians

Practice addresses (Care Compare)

1800 E Coplin St
Creek Nation Community Hospital
Okemah, OK 74859-4642
Phone (918) 623-1424

Hospital & facility affiliations

  • Council Oak Comprehensive Healthcare Hospital, Tulsa, OK, CCN 370244

Merit-based Incentive Payment System (MIPS)

Final score
96.01 of 100Reported as group
Quality
92.02
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00805KSMDAddiction (Substance Use Disorder) Counselor
60061CAMDPharmacist
5041OKMDPhysical Therapist
1500805KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Panacea Dermatology, PA Past Accepting new patients
Carlsbad and Vista Dermatology, Inc. PastSince Jul 1, 2017 Accepting new patients
Sergio Marano O.D. Mark Grisar O.D. PC PastSince May 28, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1235244302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6399 SAN IGNACIO AVE STE 120",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951191215",
            "telephone_number": "913-424-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 GARDEN VIEW CT STE 100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242478",
            "telephone_number": "760-633-1000",
            "fax_number": "760-753-8657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1934 Via Ctr Ste B",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920816056",
            "country_code": "US",
            "telephone_number": "760-295-2299",
            "fax_number": "760-216-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "DENISE",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1500805",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100402570A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.