Individual provider Active NPI

Pavitra Parekh, PA-C

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1245958743
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3325 Palo Verde Ave Ste 107
Long Beach, CA 90808-4132
Phone
(562) 420-8333
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 CA Primary

Addresses

Primary practice location

3325 Palo Verde Ave Ste 107
Long Beach, CA 90808-4132

Mailing address

367 Glacier Way
San Rafael, CA 94903-2205
Phone (628) 253-3527

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL pavitp@uw.edu

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
I20240409003904 CA Practitioner - Physician Assistant 3870931892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Dermatology PCGroup PAC ID 0840629812, 4 clinicians
Integrated Dermatology and Dermatopathology IncGroup PAC ID 0840391843, 3 clinicians
Permanente Medical Group IncGroup PAC ID 8921910225, shared by 2 NPIs, 10,928 clinicians

Practice addresses (Care Compare)

18800 Main St
Suite 111
Huntington Beach, CA 92648-1717
Phone (714) 951-9119

3325 Palo Verde Ave
Long Beach, CA 90808-4132
Phone (562) 420-8333

4125 Bangs Ave
Modesto, CA 95356-8713
Phone (209) 735-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63453CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mismo Dermatology Group Apc PastSince Jan 1, 2024 Accepting new patients

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1245958743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 GLACIER WAY",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032205",
            "telephone_number": "628-253-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 PALO VERDE AVE STE 107",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908084132",
            "telephone_number": "562-420-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREKH",
        "first_name": "PAVITRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pavitp@uw.edu",
            "affiliation": "N",
            "address_1": "4311 11th Ave NE Ste 200",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981056367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.