NPIMap

Individual provider Active NPI

Meenal D Mistry, PA-C

  • Physician Assistant
  • Palo Alto, CA
National Provider Identifier
1386951770
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
21148 Issued in CA
Practice address
795 El Camino Real
Palo Alto, CA 94301-2302
Phone
(650) 330-4533
NPI assigned
Sep 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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 21148 CA Primary

Addresses

Primary practice location

795 El Camino Real
Palo Alto, CA 94301-2302

Mailing address

1804 Embarcadero Rd
Ste 100
Palo Alto, CA 94303-3318
Phone (650) 498-5710

Other names 1

  • Meenal Dewagan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110302000486 CA Practitioner - Physician Assistant 6103007778 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Sand Creek Rd
Suite a
Brentwood, CA 94513-2539
Phone (925) 939-8585

2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Phone (925) 939-8585

2625 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 939-8585

5201 Norris Canyon Rd
San Ramon, CA 94583-5405
Phone (925) 939-8585

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine CurrentSince Mar 1, 2023 Accepting new patients
Stanford Health Care CurrentSince Jun 24, 2013 Accepting new patients
Sah Orthopaedic Associates CurrentSince Oct 25, 2017 Accepting new patients
Sah Orthopaedic Associates CurrentSince Oct 25, 2017 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Mar 1, 2023 Accepting new patients
Stanford Health Care CurrentSince Jun 24, 2013 Accepting new patients
Sequoia Health Services Past Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients
John Muir Health Past Accepting new patients
Sutter Delta Medical Center Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients
John Muir Health Past Accepting new patients
MSK-US, Inc. PastSince Jun 5, 2011 Accepting new patients

Locations

101 Sand Creek Rd
#A
Brentwood, CA 94513
Phone (925) 978-6959

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

695 Oak Grove Ave
Ste 200
Menlo Park, CA 94025
Phone (510) 818-7200

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

2625 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 210-8500

Interoperability endpoints

  • Direct secure messaging: meena.mistry.d1.p1@direct.muirortho.nextgenshare.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1386951770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EMBARCADERO RD",
            "address_2": "STE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033318",
            "telephone_number": "650-498-5710",
            "fax_number": "650-498-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 EL CAMINO REAL",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012302",
            "telephone_number": "650-330-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "MEENAL",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEENAL",
            "last_name": "DEWAGAN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.