Individual provider Active NPI

Kamille Resetz, PA

  • Physician Assistant
  • Travis Afb, CA
National Provider Identifier
1235430158
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
57034 Issued in CA
Practice address
531 Waldron St Ste D
Travis Afb, CA 94535-2125
Phone
(707) 424-3812
NPI assigned
Nov 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57034 CA Primary

Addresses

Primary practice location

531 Waldron St Ste D
Travis Afb, CA 94535-2125

Mailing address

531 Waldron St Ste D
Travis Afb, CA 94535-2125
Phone (707) 424-3812

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
I20230816001559 CA Practitioner - Physician Assistant 8123214723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Plus Telehealth IncGroup PAC ID 0941630123, 27 clinicians

Practice addresses (Care Compare)

1387 E 2ND St
Benicia, CA 94510-2836
Phone (707) 377-1005

2360 1St St
Napa, CA 94559-2239
Phone (707) 377-1007

446 W Napa St
Sonoma, CA 95476-6519
Phone (707) 690-5332

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Plus Telehealth Inc CurrentSince May 22, 2023 Accepting new patients
Urgent Care Plus Telehealth Inc PastSince Dec 13, 2022 Accepting new patients

Locations

1387 E 2nd St
Benicia, CA 94510
Phone (707) 377-1005

2360 1st St
Napa, CA 94559
Phone (707) 377-1007

446 W Napa St
Sonoma, CA 95476
Phone (707) 690-5332

Interoperability endpoints

  • Direct secure messaging: kamille.resetz.1@21754.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1235430158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 WALDRON ST STE D",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945352125",
            "telephone_number": "707-424-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 WALDRON ST STE D",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945352125",
            "telephone_number": "707-424-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESETZ",
        "first_name": "KAMILLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.