Individual provider Active NPI

Susan Solar Pers, PA-C

  • Physician Assistant
  • San Ramon, CA
National Provider Identifier
1245855527
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58166 Issued in CA
Practice address
200 Porter Dr
San Ramon, CA 94583-1587
Phone
(925) 838-2108
NPI assigned
Jun 11, 2020
Last updated
Mar 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

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 58166 CA Primary

Addresses

Primary practice location

200 Porter Dr
San Ramon, CA 94583-1587

Mailing address

200 Porter Dr
San Ramon, CA 94583-1587
Phone (925) 838-2108

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
I20210531000014 CA Order and Referring Only - Physician Assistant 3971902651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58166CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Shasta Diablo, Inc PastSince Mar 5, 2023 Accepting new patients
Planned Parenthood Shasta Diablo Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: susan.perspa.p1@direct.ppnorcal.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1245855527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PORTER DR",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831587",
            "telephone_number": "925-838-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PORTER DR",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831587",
            "telephone_number": "925-838-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERS",
        "first_name": "SUSAN",
        "middle_name": "SOLAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.