Individual provider Active NPI

Marzia Mujaddide, PA-C

  • Physician Assistant
  • Modesto, CA
National Provider Identifier
1548508369
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22212 Issued in CA
Practice address
600 Coffee Rd
Modesto, CA 95355-4201
Phone
(209) 569-7408
NPI assigned
Jan 29, 2013
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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 22212 CA Primary

Addresses

Primary practice location

600 Coffee Rd
Modesto, CA 95355-4201

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

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
I20130222000210 CA Practitioner - Physician Assistant 7214182286 Reassigns benefits to 13 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chabot Family Associates IncGroup PAC ID 6204152408, 2 clinicians

Practice addresses (Care Compare)

19845 Lake Chabot Rd
Suite 205
Castro Valley, CA 94546-4055
Phone (510) 582-6424

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Sep 12, 2022 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jan 1, 2016 Accepting new patients
California Emergency Physicians Medical Group a Professional Corp CurrentSince Feb 2, 2016 Accepting new patients
University of California San Francisco CurrentSince Sep 12, 2022 Accepting new patients
Galen Inpatient Physicians Inc CurrentSince Jan 1, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 12, 2022 Accepting new patients
Cep America-California CurrentSince Mar 2, 2014 Accepting new patients
Cep America - California CurrentSince Mar 2, 2014 Accepting new patients
University of California San Francisco CurrentSince Sep 12, 2022 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Mar 8, 2021 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Mar 8, 2021 Accepting new patients
California Emergency Physicians Medical Group, a Professional Corp. CurrentSince Feb 2, 2016 Accepting new patients
Nirmala Kannan M.D. a Professional Corporation Past Accepting new patients
West Coast Veins and Vascular Inc Past Accepting new patients
Nirmala Kannan, M.D. Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Vepema Medical Group Past Accepting new patients
Rajesh S Suri Past Accepting new patients
Umer Malik Corporation Past Accepting new patients
Yoshihiro Katsuura Professional Corporation PastSince Apr 15, 2023 Accepting new patients

Locations

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

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

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

179 Fairview Ln
Sonora, CA 95370
Phone (209) 536-3850

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Interoperability endpoints

  • Direct secure messaging: mmujaddide166948@hpmg.direct-ci.net

Organizations & group practices 31

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.

View all 31

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": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1548508369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-569-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUJADDIDE",
        "first_name": "MARZIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.