Individual provider Active NPI

Beatriz Marlene Rubio Damian, P.A.

  • Physician Assistant
  • Placerville, CA
National Provider Identifier
1497880637
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
18716 Issued in CA
Practice address
5168 Honpie Rd
Placerville, CA 95667-8682
Phone
(530) 387-4975
Fax
(530) 387-8006
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 18716 CA Primary

Addresses

Primary practice location

5168 Honpie Rd
Placerville, CA 95667-8682

Mailing address

5168 Honpie Rd
Placerville, CA 95667-8682
Phone (530) 387-4975

Other names 1

  • Marlene Rubio Damian 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
I20090910000233 CA Practitioner - Physician Assistant 0941355218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shingle Springs RancheriaGroup PAC ID 6002863271, 16 clinicians

Practice addresses (Care Compare)

5168 Honpie Rd
Placerville, CA 95667-8682
Phone (530) 387-4975

Hospital & facility affiliations

  • Marshall Medical Center Hospital, Placerville, CA, CCN 050254

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1497880637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5168 HONPIE RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678682",
            "telephone_number": "530-387-4975",
            "fax_number": "530-387-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5168 HONPIE RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956678682",
            "telephone_number": "530-387-4975",
            "fax_number": "530-387-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO DAMIAN",
        "first_name": "BEATRIZ",
        "middle_name": "MARLENE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "18716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLENE",
            "last_name": "RUBIO DAMIAN",
            "credential": "P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.