Individual provider Active NPI

Roseanna Pauli Bains, PA-C

  • Physician Assistant
  • Roseville, CA
National Provider Identifier
1295393379
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
56806 Issued in CA
Practice address
3005 Douglas Blvd Ste 105
Roseville, CA 95661-3885
Phone
(916) 742-7718
NPI assigned
Jun 3, 2019
Last updated
Apr 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 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 56806 CA Primary

Addresses

Primary practice location

3005 Douglas Blvd Ste 105
Roseville, CA 95661-3885

Mailing address

3005 Douglas Blvd Ste 105
Roseville, CA 95661-3885

Other practice location 1

924 57th St
Sacramento, CA 95819-3328
Phone (916) 287-1725

Other names 1

  • Roseanna Meade Pauli Former name

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
I20191004003115 CA Practitioner - Physician Assistant 7810228830 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56806CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter West Bay Medical Foundation Physician Assistant PastSince Apr 23, 2023 Accepting new patients

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1295393379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 DOUGLAS BLVD STE 105",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 DOUGLAS BLVD STE 105",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613885",
            "telephone_number": "916-742-7718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "924 57th St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958193328",
            "country_code": "US",
            "telephone_number": "916-287-1725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAINS",
        "first_name": "ROSEANNA",
        "middle_name": "PAULI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEANNA",
            "last_name": "PAULI",
            "middle_name": "MEADE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.