Selise James, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21186 Issued in CA

Practice address

2552 Walnut Ave
#120
Tustin, CA 92780-6935

Phone

(714) 508-0754

Fax

(714) 508-5754

NPI assigned

Jan 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• J Robert West, M.D., Inc

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1932154788
  Medicare reassignment NPD
• South Coast Dermatology Institute, a Medical Corporation

  • Dermatology Physician
  • Tustin, CA
  • NPI 1033241138
  Medicare reassignment

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1457749061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 WALNUT AVE",
            "address_2": "#120",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806935",
            "telephone_number": "714-508-0754",
            "fax_number": "714-508-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 WALNUT AVE",
            "address_2": "#120",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806935",
            "telephone_number": "714-508-0754",
            "fax_number": "714-508-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "SELISE",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vijay Jain, DMD
• Jamboree Optometry Inc
• Jamellow LLC
• James Q Bui DDS a Professional Dental Corporation
• Hana Mae James, PT, DPT
• Lisa Jamison
• Gilda Jani, L.AC.
• Nadine Jarjur, PHARMD
• Kelli Jarvis, PSY.D.
• Jasleen Brar DDS Inc

• Medical Physician Assistant in Tustin, CA
• Providers in Tustin, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.