Individual provider Active NPI

Annie Humphrey, PA-C

  • Medical Physician Assistant
  • Danville, CA
National Provider Identifier
1427681535
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA58037 Issued in CA
Practice address
4165 Blackhawk Plaza Cir
Ste 100
Danville, CA 94506-4691
Phone
(925) 736-7070
Fax
(925) 736-7075
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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 PA58037 CA Primary

Addresses

Primary practice location

4165 Blackhawk Plaza Cir
Ste 100
Danville, CA 94506-4691

Mailing address

4165 Blackhawk Plaza Cir
Ste 100
Danville, CA 94506-4691
Phone (925) 736-7070

Other names 1

  • Annie Humphrey Other name

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
I20200506001588 CA Practitioner - Physician Assistant 1153752126 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58037CAMDRegistered Nurse
PA58037CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Jul 22, 2020 Accepting new patients
Bass Medical Group Current Accepting new patients
County of Santa Clara CurrentSince Jul 22, 2020 Accepting new patients
Cep America - California CurrentSince Jul 1, 2022 Accepting new patients
County of Santa Clara CurrentSince Jul 22, 2020 Accepting new patients
County of Santa Clara CurrentSince Jul 22, 2020 Accepting new patients
Bass Medical Group CurrentSince May 15, 2020 Accepting new patients
Cep America - California CurrentSince Jul 1, 2022 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

4165 Blackhawk Plaza Cir
Ste 100
Danville, CA 94506
Phone (925) 736-7070

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: ann.humphrey@299395540647940.direct.elationemr.com
  • Direct secure messaging: ahumphrey49922@ehr.johnmuirhealth.com
  • Direct secure messaging: ahumphrey136894@santaclaravalley.direct-ci.net

Organizations & group practices 12

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": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1427681535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR",
            "address_2": "STE 100",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064691",
            "telephone_number": "925-736-7070",
            "fax_number": "925-736-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR",
            "address_2": "STE 100",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064691",
            "telephone_number": "925-736-7070",
            "fax_number": "925-736-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "ANNIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA58037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "HUMPHREY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Danville, CA

Sources for this page

Verify at the official NPI Registry.