Individual provider Active NPI

David Augustine Lague, MPA-C

  • Medical Physician Assistant
  • Redwood City, CA
National Provider Identifier
1295979227
Registry record updated Jan 16, 2017
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(4) exclusion effective Jun 20, 2019.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA16903 Issued in CA
Practice address
363 Main St
Suite C
Redwood City, CA 94063-1729
Phone
(650) 562-6466
Fax
(650) 306-0250
NPI assigned
Apr 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA16903 CA Primary

Addresses

Primary practice location

363 Main St
Suite C
Redwood City, CA 94063-1729

Mailing address

363 Main St
Suite C
Redwood City, CA 94063-1729
Phone (650) 562-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16903CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mannie Joel MD Inc. Past Accepting new patients

Organizations & group practices 1

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": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1295979227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 MAIN ST",
            "address_2": "SUITE C",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631729",
            "telephone_number": "650-562-6466",
            "fax_number": "650-306-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 MAIN ST",
            "address_2": "SUITE C",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631729",
            "telephone_number": "650-562-6466",
            "fax_number": "650-306-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGUE",
        "first_name": "DAVID",
        "middle_name": "AUGUSTINE",
        "credential": "MPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-21",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA16903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.