Individual provider Active NPI

Patricia Ka NG, PA-C

  • Physician Assistant
  • San Ramon, CA
National Provider Identifier
1558085647
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2262 Camino Ramon
San Ramon, CA 94583-1353
Phone
(925) 328-0255
Fax
(925) 328-0257
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 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

2262 Camino Ramon
San Ramon, CA 94583-1353

Mailing address

2262 Camino Ramon
San Ramon, CA 94583-1353
Phone (925) 328-0255

Other practice location 1

3860 Blackhawk Rd Ste 140
Danville, CA 94506-4832
Phone (925) 837-6000

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
I20231226000828 CA Practitioner - Physician Assistant 4981054483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Dermatology Care IncGroup PAC ID 2264564574, 8 clinicians

Practice addresses (Care Compare)

2262 Camino Ramon
San Ramon, CA 94583-1353
Phone (925) 328-0255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61746CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hayes B. Gladstone, MD, PC. CurrentSince Dec 17, 2023 Accepting new patients
Hayes B. Gladstone, MD, PC. CurrentSince Oct 1, 2022 Accepting new patients

Locations

3860 Blackhawk Rd
Ste 140
Danville, CA 94506
Phone (925) 837-6000

Organizations & group practices 3

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": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1558085647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2262 CAMINO RAMON",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831353",
            "telephone_number": "925-328-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2262 CAMINO RAMON",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831353",
            "telephone_number": "925-328-0255",
            "fax_number": "925-328-0257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3860 Blackhawk Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "CA",
            "postal_code": "945064832",
            "country_code": "US",
            "telephone_number": "925-837-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "PATRICIA",
        "middle_name": "KA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.