Active NPI
Anthony Menacho, PA-C
- Physician Assistant
- Woodland, CA
National Provider Identifier
1386290195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 57047
- Practice address
- 215 W Beamer St
Woodland, CA 95695-2510 - Phone
- (307) 582-0605
- NPI assigned
- Aug 16, 2019
- 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 | 57047 | CA | Primary |
Addresses
Primary practice location
215 W Beamer St
Woodland, CA 95695-2510
Mailing address
2472 Larkspur LN Apt 363
Sacramento, CA 95825-4153
Phone (909) 730-5241
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ole Health | Current | Accepting new patients | |
| Sacramento Street Medicine | Current | Accepting new patients | |
| Ole Health | Past | Accepting new patients |
Locations
2051 John Jones Rd
Davis, CA 95616
Phone (530) 753-3498
2211 Del Paso Blvd
Ste B
Sacramento, CA 95815
215 W Beamer St
Woodland, CA 95695
Phone (530) 405-2800
Interoperability endpoints
- amenacho675843@direct.ochin.org
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.
-
- Public Health & General Preventive Medicine Physician
- Sacramento, CA
- NPI 1548989692
-
dba CommuniCare OLE
- Federally Qualified Health Center (FQHC)
- West Sacramento, CA
- NPI 1881330579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1386290195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2472 LARKSPUR LN APT 363",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958254153",
"telephone_number": "909-730-5241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W BEAMER ST",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956952510",
"telephone_number": "307-582-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENACHO",
"first_name": "ANTHONY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-16",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "57047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.