Individual provider Active NPI

Mary Mecca, PA

  • Physician Assistant
  • Fremont, CA
National Provider Identifier
1508544636
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
40910 Fremont Blvd
Fremont, CA 94538-4375
Phone
(510) 770-8133
NPI assigned
Jul 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 Primary

Addresses

Primary practice location

40910 Fremont Blvd
Fremont, CA 94538-4375

Mailing address

40910 Fremont Blvd
Fremont, CA 94538-4375
Phone (510) 770-8133

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
I20251022004381 CA Practitioner - Physician Assistant 6901258060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 National Dr
Suite 135
Sacramento, CA 95834-1947

40910 Fremont Blvd
Fremont, CA 94538-4375

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Community Health CurrentSince Aug 4, 2025 Accepting new patients
Bay Area Community Health Past Accepting new patients

Locations

40910 Fremont Blvd
Fremont, CA 94538
Phone (510) 770-8133

1860 Mowry Ave
Fremont, CA 94538
Phone (510) 608-6065

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1508544636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-770-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40910 FREMONT BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945384375",
            "telephone_number": "510-770-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECCA",
        "first_name": "MARY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.