Individual provider Active NPI

Noelle Capulong, PA

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1275195760
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA53600 Issued in CA
Practice address
2033 Gateway Place
5TH Floor, Office 647
San Jose, CA 95110
Phone
(657) 500-0634
NPI assigned
Jul 3, 2019
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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 PA53600 CA Primary

Addresses

Primary practice location

2033 Gateway Place
5TH Floor, Office 647
San Jose, CA 95110

Mailing address

68 Harrison Ave Ste 600
Boston, MA 02111-1995
Phone (657) 500-0634

Other identifiers 1

IdentifierTypeStateIssuer
PA53600OtherCAPHYSICIAN ASSISTANT BOARD OF CALIFORNIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240115001452 WA Practitioner - Physician Assistant 0143672220 Reassigns benefits to 1 organization
I20240430001831 CA Practitioner - Physician Assistant 0143672220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bicycle Health Medical Group PAGroup PAC ID 0244643872, 23 clinicians
Bicycle Health Provider Group IncGroup PAC ID 8527395334, 5 clinicians

Practice addresses (Care Compare)

1700 Westlake Ave N
Suite 200
Seattle, WA 98109-6212
Phone (844) 943-2514

2033 Gateway PL
San Jose, CA 95110-3709
Phone (844) 943-2514

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA53600CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rume Medical Group, Inc. CurrentSince Jul 21, 2024 Accepting new patients

Locations

2729 Bristol St
Costa Mesa, CA 92626
Phone (657) 256-8995

19722 MacArthur Blvd
Ste 110
Irvine, CA 92612
Phone (844) 540-4357

Interoperability endpoints

  • Direct secure messaging: noelle.capulong.1@18731.direct.athenahealth.com
  • Direct secure messaging: noelle.capulong@398008301912068.direct.elationemr.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, 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": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1275195760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 HARRISON AVE STE 600",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111995",
            "telephone_number": "657-500-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 GATEWAY PLACE",
            "address_2": "5TH FLOOR, OFFICE 647",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95110",
            "telephone_number": "657-500-0634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPULONG",
        "first_name": "NOELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA53600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT BOARD OF CALIFORNIA",
            "identifier": "PA53600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.