Lara Barhoum Demaio, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

55379 Issued in CA

Practice address

11634 Fair Oaks Blvd
Fair Oaks, CA 95628

Phone

(916) 983-8868

NPI assigned

Aug 4, 2016

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthy Living Primary Care IncGroup PAC ID 7618062225, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Healthy Living Primary Care, Inc

  • Family Medicine Physician
  • Folsom, CA
  • NPI 1144414293
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1467906610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11634 FAIR OAKS BLVD",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283771",
            "telephone_number": "916-983-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11634 FAIR OAKS BLVD",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "95628",
            "telephone_number": "916-983-8868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "328 W Saint Georges Ave",
            "address_purpose": "LOCATION",
            "city": "Linden",
            "state": "NJ",
            "postal_code": "070365638",
            "country_code": "US",
            "telephone_number": "908-925-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMAIO",
        "first_name": "LARA",
        "middle_name": "BARHOUM",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "55379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine De Guzman, MSW, ACSW
• Maria Teresa Ramos De Guzman, DDS
• Carla Gayl De Rose, MFT
• Macie Miken Delaney, RADT
• David Martin Delapp, D.C.
• Dental Excellence Inc
• Dentists Dynamic Services Inc (Deguzman Childrens Dentistry and Orthodontics)
• Aleksey Derevyanchuk, CADC II
• Bridget Mary Deterding
• Jerome Devase

• Medical Physician Assistant in Fair Oaks, CA
• Providers in Fair Oaks, 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 Jul 3, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.