Active NPI
Mark Oribello, PA-C, MPH
- Physician Assistant
- Travis, CA
National Provider Identifier
1356582654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA19313
- Practice address
- 101 Bodin Circle, Travis AFB
Travis, CA 94535-1800 - Phone
- (408) 313-0173
- NPI assigned
- Mar 16, 2009
- Last updated
- Jan 15, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA19313 | CA | Primary |
Addresses
Primary practice location
101 Bodin Circle, Travis AFB
Travis, CA 94535-1800
Mailing address
101 Bodin Circle, Travis AFB
Travis, CA 94535-1800
Phone (408) 313-0173
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231004002297 | CA | Order and Referring Only - Physician Assistant | 8820239940 |
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": "1237161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452816000000",
"number": "1356582654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BODIN CIRCLE, TRAVIS AFB",
"city": "TRAVIS",
"state": "CA",
"postal_code": "945351800",
"telephone_number": "408-313-0173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIRCLE, TRAVIS AFB",
"city": "TRAVIS",
"state": "CA",
"postal_code": "945351800",
"telephone_number": "408-313-0173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ORIBELLO",
"first_name": "MARK",
"credential": "PA-C, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-16",
"last_updated": "2016-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA19313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Travis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.