Individual provider Active NPI

Sherri N Anderson, PA

  • Physician Assistant
  • Westlake Village, CA
National Provider Identifier
1366611774
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA57066 Issued in CA
Practice address
32144 Agoura Rd Ste 112
Westlake Village, CA 91361-4043
Phone
(818) 889-2739
Fax
(818) 889-2747
NPI assigned
Feb 29, 2008
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 57066 CA
Physician Assistant 363A00000X PA57066 CA Primary
Emergency Medicine Physician 207P00000X 0110002719 MD

Addresses

Primary practice location

32144 Agoura Rd Ste 112
Westlake Village, CA 91361-4043

Mailing address

32144 Agoura Rd Ste 112
Westlake Village, CA 91361-4043
Phone (818) 889-2739

Other practice location 1

8700 Sudley Road
Prince William Hospital
Manassas, VA 20110
Phone (703) 369-8337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080502000276 VA Practitioner - Physician Assistant 4880773845 Reassigns benefits to 1 organization
I20191107002825 CA Practitioner - Physician Assistant 4880773845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Karin I Harp MD IncGroup PAC ID 7810134459, 8 clinicians

Practice addresses (Care Compare)

32144 Agoura Rd
Suite 112
Westlake Village, CA 91361-4043
Phone (818) 889-2739

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002719MDMDEmergency Medicine Physician
PA57066CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Emergency Physicians PC Physician Assistant PastSince Apr 17, 2020 Accepting new patients
Providence Health System - Southern California Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1366611774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD STE 112",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614043",
            "telephone_number": "818-889-2739",
            "fax_number": "818-889-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD STE 112",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614043",
            "telephone_number": "818-889-2739",
            "fax_number": "818-889-2747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Sudley Road",
            "address_2": "Prince William Hospital",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "20110",
            "country_code": "US",
            "telephone_number": "703-369-8337",
            "fax_number": "703-369-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHERRI",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57066",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57066",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "0110002719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.