Individual provider Active NPI

Annamae Minard, PA-C

  • Medical Physician Assistant
  • Riverside, CA
National Provider Identifier
1427019702
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA16007 Issued in CA
Practice address
6848 Magnolia Ave
#250
Riverside, CA 92506-2857
Phone
(951) 682-1622
Fax
(951) 682-1268
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA16007 CA Primary

Addresses

Primary practice location

6848 Magnolia Ave
#250
Riverside, CA 92506-2857

Mailing address

3619 Hancock Dr
Riverside, CA 92503-5015
Phone (951) 688-1171

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
I20140731000776 CA Practitioner - Physician Assistant 5395961163 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16007CAMDProfessional Counselor
PA16007CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orangecrest Medical Group, Inc. PastSince Apr 1, 2020 Accepting new patients
Larry H Couture MD Inc Past Accepting new patients
Lumina Family Care, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEHIBA/Endpoint/HEHIBA

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1427019702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 HANCOCK DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035015",
            "telephone_number": "951-688-1171",
            "fax_number": "951-688-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6848 MAGNOLIA AVE",
            "address_2": "#250",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062857",
            "telephone_number": "951-682-1622",
            "fax_number": "951-682-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINARD",
        "first_name": "ANNAMAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA16007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.