Individual provider Active NPI

Stephanie Sin Eng, PA-C

  • Physician Assistant
  • Dublin, CA
National Provider Identifier
1376081208
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
54214 Issued in CA
Practice address
11823 Kilcullin CT
Dublin, CA 94568-2352
Phone
(925) 918-1131
NPI assigned
Feb 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 54214 CA Primary

Addresses

Primary practice location

11823 Kilcullin CT
Dublin, CA 94568-2352

Mailing address

11823 Kilcullin CT
Dublin, CA 94568-2352

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
I20210922002400 CA Practitioner - Physician Assistant 3779980446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

901 Nevin Ave
Richmond, CA 94801-3143
Phone (510) 307-1500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Jun 5, 2021 Accepting new patients
Permanente Medical Group Inc CurrentSince Jun 5, 2021 Accepting new patients

Locations

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

3772 Howe St
Piedmont, CA 94611
Phone (510) 752-1235

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Interoperability endpoints

  • Direct secure messaging: seng90491@santaclaravalley.direct-ci.net

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": "1486771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1376081208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11823 KILCULLIN CT",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11823 KILCULLIN CT",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945682352",
            "telephone_number": "925-918-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENG",
        "first_name": "STEPHANIE",
        "middle_name": "SIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-11",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3772 Howe St",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946115311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dublin, CA

Sources for this page

Verify at the official NPI Registry.