Individual provider Active NPI

Chantal Angelique Fry, PA

  • Medical Physician Assistant
  • San Jose, CA
National Provider Identifier
1477280006
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61339 Issued in CA
Practice address
2105 Forest Ave
San Jose, CA 95128-1425
Phone
(408) 947-2500
NPI assigned
Aug 3, 2022
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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 PA61339 CA Primary

Addresses

Primary practice location

2105 Forest Ave
San Jose, CA 95128-1425

Mailing address

2105 Forest Ave
San Jose, CA 95128-1425
Phone (408) 947-2500

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 1447724646 Direct

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
I20220927001561 CA Practitioner - Physician Assistant 3678959764 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

15400 Los Gatos Blvd
Los Gatos, CA 95032-2502
Phone (408) 739-6000

1760 S Bascom Ave
Suite 140
Campbell, CA 95008-0638
Phone (408) 214-9732

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

377 Santana Row
Suite 1180
San Jose, CA 95128-2061
Phone (669) 247-4773

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61339CAMDPharmacist
PA61339CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Nov 4, 2024 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Monica Perlman MD Inc. CurrentSince Feb 10, 2026 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Mar 1, 2023 Accepting new patients
Emergency Physicians Urgent Care Inc. CurrentSince Jul 25, 2025 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Nov 4, 2024 Accepting new patients
Sutter West Bay Medical Foundation Past Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Locations (25 of 29)

2690 5th St
Ste B
Alameda, CA 94501
Phone (510) 439-9447

18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590

212 Coffee Rd
Ste 100
Bakersfield, CA 93309
Phone (661) 885-6060

9710 Brimhall Rd
Bakersfield, CA 93312
Phone (661) 829-6741

1760 S Bascom Ave
Ste 140
Campbell, CA 95008
Phone (408) 214-9732

4108 Edison Ave
Ste 112
Chino, CA 91710
Phone (909) 334-4545

32860 Pacific Coast Hwy
Ste 24
Dana Point, CA 92629
Phone (949) 441-2922

1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777

6789 N Blackstone Ave
Fresno, CA 93710
Phone (559) 512-3377

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

15400 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 523-3102

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200

401 Grand Ave
#1112
Oakland, CA 94610
Phone (800) 756-4206

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

46 Hillsdale Mall
San Mateo, CA 94403
Phone (650) 769-5612

Interoperability endpoints

  • Direct secure messaging: cfry189014@santaclaravalley.direct-ci.net
  • Direct secure messaging: cfry575690@hisp.ehr.sutterhealth.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1477280006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 FOREST AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281425",
            "telephone_number": "408-947-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 FOREST AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281425",
            "telephone_number": "408-947-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "CHANTAL",
        "middle_name": "ANGELIQUE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA61339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "1447724646",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2105 Forest Ave",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951281425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.