Individual provider Active NPI

Danielle Antonette Swanson, PA-C

  • Surgical Physician Assistant
  • Orange, CA
National Provider Identifier
1306155007
Registry record updated Oct 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA21161 Issued in CA
Practice address
1100 W Stewart Dr
Orange, CA 92868-3849
Phone
(714) 633-9111
NPI assigned
Sep 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21161 CA
Surgical Physician Assistant 363AS0400X PA21161 CA Primary

Addresses

Primary practice location

1100 W Stewart Dr
Orange, CA 92868-3849

Mailing address

22431 Antonio Pkwy # B160-613
Rancho Santa Margarita, CA 92688-2804
Phone (833) 477-2677

Other practice location 1

22431 Antonio Pkwy # B160-613
Rancho Santa Margarita, CA 92688-2804
Phone (833) 477-2677

Other names 1

  • Danielle Antonette Haberern 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
I20110223000921 CA Practitioner - Physician Assistant 0143401109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthcare Service Partners IncGroup PAC ID 0648557363, 10 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (833) 477-2677

Hospital & facility affiliations

  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21161CAMDPhysical Therapist
PA21161CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MSK-US, Inc. PastSince Jun 5, 2011 Accepting new patients
Physician Assistant Specialists-California Inc Physician Assistant PastSince Oct 8, 2023 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603497600000",
    "number": "1306155007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22431 ANTONIO PKWY # B160-613",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882804",
            "telephone_number": "833-477-2677",
            "fax_number": "833-477-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W STEWART DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849",
            "telephone_number": "714-633-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22431 Antonio Pkwy # B160-613",
            "address_purpose": "LOCATION",
            "city": "Rancho Santa Margarita",
            "state": "CA",
            "postal_code": "926882804",
            "country_code": "US",
            "telephone_number": "833-477-2677",
            "fax_number": "833-477-2677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "DANIELLE",
        "middle_name": "ANTONETTE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2020-10-24",
        "certification_date": "2020-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21161",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA21161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "HABERERN",
            "middle_name": "ANTONETTE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.