Alyssa Pantle, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

12660 Riverside Dr
Valley Village, CA 91607-3429

Phone

(818) 769-5998

Fax

(818) 769-5004

NPI assigned

Feb 9, 2023

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Joseph R Shapiro MD, Inc.

  • Allergy & Immunology Physician
  • Studio City, CA
  • NPI 1033549589
  Medicare reassignment
• Star Urology Incorporated

  • Urology Physician
  • Glendale, CA
  • NPI 1801113824
  Medicare reassignment

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1558068643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "address_2": "ST 325",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "91607",
            "telephone_number": "818-769-5998",
            "fax_number": "818-769-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12660 RIVERSIDE DR",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073429",
            "telephone_number": "818-769-5998",
            "fax_number": "818-769-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTLE",
        "first_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Open Access Care Professional Corporation
• Orthovive Physical Therapy & Wellness, Inc.
• Staci Marazoni Paciorek, D.C.
• Jasmyn Joyce Page
• Panakeia Hospice, Inc.
• Lauren Michelle Papa, D.C.
• Aldo Parra
• Rita Parsamyan Mahood, NP
• Andrea Patin
• Paul D Zau DDS Inc

• Physician Assistant in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.