Individual provider Active NPI

Ghazel Waiz, PA-C

  • Medical Physician Assistant
  • Fairfield, CA
National Provider Identifier
1265015077
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA59458 Issued in CA
Practice address
1843 Atwoodville CT
Fairfield, CA 94533-8996
Phone
(707) 416-5571
NPI assigned
Apr 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA59458 CA
Medical Physician Assistant 363AM0700X PA59458 CA Primary

Addresses

Primary practice location

1843 Atwoodville CT
Fairfield, CA 94533-8996

Mailing address

1843 Atwoodville CT
Fairfield, CA 94533-8996
Phone (707) 416-5571

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
I20221107001761 CA Practitioner - Physician Assistant 6608243514 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

327 Main St
Rio Vista, CA 94571-1738
Phone (707) 646-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA59458CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Nov 21, 2025 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Northbay Health Medical Foundation CurrentSince Jan 1, 2026 Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

327 Main St
Rio Vista, CA 94571
Phone (707) 374-1412

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

1679 E Monte Vista Ave
Ste 104
Vacaville, CA 95688
Phone (707) 624-7400

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Organizations & group practices 5

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": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1265015077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 ATWOODVILLE CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945338996",
            "telephone_number": "707-416-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 ATWOODVILLE CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945338996",
            "telephone_number": "707-416-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIZ",
        "first_name": "GHAZEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "PA59458",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA59458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.