Individual provider Active NPI

Charmaine Pamintuan Santos, PA-C

  • Physician Assistant
  • Antioch, CA
National Provider Identifier
1386341576
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3903 Lone Tree Way Ste 104
Antioch, CA 94509-6251
Phone
(925) 755-1255
Fax
(925) 755-1259
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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 Primary

Addresses

Primary practice location

3903 Lone Tree Way Ste 104
Antioch, CA 94509-6251

Mailing address

3903 Lone Tree Way Ste 104
Antioch, CA 94509-6251
Phone (925) 755-1255

Other practice location 1

3100 Telegraph Ave
Oakland, CA 94609-3239
Phone (800) 607-6377

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
I20231129003510 CA Practitioner - Physician Assistant 6608224761 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Medical Group CurrentSince Oct 11, 2023 Accepting new patients
Bass Medical Group CurrentSince Oct 11, 2023 Accepting new patients
Bass Medical Group Past Accepting new patients
Bass Medical Group Past Accepting new patients

Locations

1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225

3903 Lone Tree Way
Ste 104
Antioch, CA 94509
Phone (415) 755-1255

2637 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 627-3424

Organizations & group practices 4

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1386341576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 LONE TREE WAY STE 104",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096251",
            "telephone_number": "925-755-1255",
            "fax_number": "925-755-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 LONE TREE WAY STE 104",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096251",
            "telephone_number": "925-755-1255",
            "fax_number": "925-755-1259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Telegraph Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093239",
            "country_code": "US",
            "telephone_number": "800-607-6377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "CHARMAINE",
        "middle_name": "PAMINTUAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.