Individual provider Active NPI

Stephanie Annette Prater, PA-C

  • Physician Assistant
  • Carmichael, CA
National Provider Identifier
1457508103
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19854 Issued in CA
Practice address
6555 Coyle Ave
Carmichael, CA 95608-0302
Phone
(916) 536-3540
NPI assigned
Aug 25, 2008
Last updated
Mar 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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 PA19854 CA Primary

Addresses

Primary practice location

6555 Coyle Ave
Carmichael, CA 95608-0302

Mailing address

6555 Coyle Ave
Carmichael, CA 95608-0302
Phone (916) 536-3540

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
I20110419000729 CA Practitioner - Physician Assistant 3173708005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19854CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Mar 14, 2011 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Mar 14, 2011 Accepting new patients
Duke Health Lake Norman Regional Medical Center, Inc. Past Accepting new patients

Locations

3581 Palmer Dr
Ste 401
Cameron Park, CA 95682
Phone (530) 676-4122

6555 Coyle Ave
Carmichael, CA 95608
Phone (916) 536-2500

7115 Greenback Ln
Fl 2
Citrus Heights, CA 95621
Phone (916) 536-3620

7115 Greenback Ln
Fl 3
Citrus Heights, CA 95621
Phone (916) 536-3520

8001 Madison Ave
Citrus Hts, CA 95610
Phone (916) 536-2420

7911 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3950

3400 Data Dr
Fl 1
Rancho Cordova, CA 95670
Phone (916) 379-2726

2110 Professional Dr
Ste 120
Roseville, CA 95661
Phone (916) 536-2500

4400 Duckhorn Dr
Ste 100
Sacramento, CA 95834
Phone (916) 575-8000

8120 Timberlake Way
Ste 109
Sacramento, CA 95823
Phone (916) 681-6000

3939 J St
Ste 250
Sacramento, CA 95819
Phone (916) 733-6901

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1457508103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 COYLE AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080302",
            "telephone_number": "916-536-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 COYLE AVE",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080302",
            "telephone_number": "916-536-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATER",
        "first_name": "STEPHANIE",
        "middle_name": "ANNETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.