Individual provider Active NPI

Maryam Eminic

  • Physician Assistant
  • San Rafael, CA
National Provider Identifier
1316723042
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65684
Practice address
50 Acacia Ave
San Rafael, CA 94901-2298
Phone
(415) 457-4440
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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 PA65684 Primary

Addresses

Primary practice location

50 Acacia Ave
San Rafael, CA 94901-2298

Mailing address

50 Acacia Ave
San Rafael, CA 94901-2298

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
I20250811002395 CA Practitioner - Physician Assistant 9830697689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1125 Arnold Dr
Martinez, CA 94553-4121
Phone (925) 293-9163

1201 E Bidwell St
Folsom, CA 95630-3450
Phone (916) 920-6337

1390 Market St
Suite 109
San Francisco, CA 94102-5403
Phone (415) 918-5766

1760 S Bascom Ave
Suite 140
Campbell, CA 95008-0638
Phone (408) 214-9732

2580 W El Camino Real
Suite 6
Mountain View, CA 94040-1308
Phone (650) 540-8851

2690 5TH St
Suite B
Alameda, CA 94501-6584
Phone (510) 439-9447

3251 20TH Ave
Suite 320
San Francisco, CA 94132-1915
Phone (415) 480-1160

4112 E Commerce Way
Sacramento, CA 95834-9680
Phone (916) 447-6337

4156 Manzanita Ave
Suite 100
Carmichael, CA 95608-1496
Phone (916) 488-6337

46 Hillsdale Mall
San Mateo, CA 94403-3407
Phone (650) 769-5612

5434 Ygnacio Valley Rd
Suite 250
Concord, CA 94521-3874
Phone (925) 320-0854

701 Sunrise Ave
Roseville, CA 95661-4502
Phone (916) 772-6337

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of California PC CurrentSince Jun 27, 2025 Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Locations

2690 5th St
Ste B
Alameda, CA 94501
Phone (510) 439-9447

7330 El Camino Real
Atascadero, CA 93422
Phone (805) 703-2501

6971 El Camino Real
Ste 101
Carlsbad, CA 92009
Phone (760) 258-4971

11971 Central Ave
Ste B
Chino, CA 91710
Phone (909) 310-1488

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883
Phone (951) 293-4722

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

806 New Los Angeles Ave
Moorpark, CA 93021
Phone (805) 334-8650

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1316723042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ACACIA AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ACACIA AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012298",
            "telephone_number": "415-457-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMINIC",
        "first_name": "MARYAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "PA65684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.