Active NPI
Terri D Pagano, P.A.
- Physician Assistant
- Berkeley, CA
National Provider Identifier
1336158328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18304
- Practice address
- 2510 Webster St
Suite 300
Berkeley, CA 94705-2557 - Phone
- (510) 841-8700
- Fax
- (510) 295-2651
- NPI assigned
- Aug 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA18304 | CA | |
| Surgical Physician Assistant | 363AS0400X | PA18304 | CA | |
| Physician Assistant | 363A00000X | PA18304 | CA | Primary |
Addresses
Primary practice location
2510 Webster St
Suite 300
Berkeley, CA 94705-2557
Mailing address
2510 Webster St
Suite 300
Berkeley, CA 94705-2557
Phone (510) 841-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1071096 | Other | NATL COMMISSION ON CERTIF |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1336158328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 WEBSTER ST",
"address_2": "SUITE 300",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052557",
"telephone_number": "510-841-8700",
"fax_number": "510-295-2651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 WEBSTER ST",
"address_2": "SUITE 300",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052557",
"telephone_number": "510-841-8700",
"fax_number": "510-295-2651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGANO",
"first_name": "TERRI",
"middle_name": "D",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-07",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA18304",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "CA",
"license": "PA18304",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18304",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATL COMMISSION ON CERTIF",
"identifier": "1071096",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.