Individual provider Active NPI

Paul Michael Navarro, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1407938483
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
606721 Issued in CA
Practice address
39400 Paseo Padre Pkwy
Fremont, CA 94538
Phone
(510) 348-5274
Fax
(510) 248-3002
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 606721 CA Primary

Addresses

Primary practice location

39400 Paseo Padre Pkwy
Fremont, CA 94538

Mailing address

39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Phone (510) 248-3060

Electronic endpoints 1

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

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
I20060221000918 CA Practitioner - Nurse Practitioner 8123034683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
606721CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Mar 1, 2011 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group Inc CurrentSince Mar 1, 2011 Accepting new patients

Locations

39400 Paseo Padre Pkwy
Fremont, CA 94538
Phone (510) 248-3000

39350 Civic Center Dr
Fremont, CA 94538
Phone (510) 299-3791

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

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1407938483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39400 PASEO PADRE PKWY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382310",
            "telephone_number": "510-248-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39400 PASEO PADRE PKWY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "94538",
            "telephone_number": "510-348-5274",
            "fax_number": "510-248-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVARRO",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "606721",
            "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": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "39350 Civic Center Dr",
            "city": "Fremont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945382343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.