Individual provider Active NPI

Ricki Paul Nolley, PA-C, MSPAS, MPH

  • Surgical Physician Assistant
  • Concord, CA
National Provider Identifier
1578878625
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
21084 Issued in CA
Practice address
1800 Sutter St Ste 100
Concord, CA 94520-2530
Phone
(925) 939-8585
NPI assigned
Aug 13, 2010
Last updated
Nov 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 21084 CA Primary

Addresses

Primary practice location

1800 Sutter St Ste 100
Concord, CA 94520-2530

Mailing address

PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585

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
I20101011000698 CA Practitioner - Physician Assistant 8820280712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Sand Creek Rd
Suite a
Brentwood, CA 94513-2539
Phone (925) 939-8585

1800 Sutter St
Suite 100
Concord, CA 94520-2530
Phone (925) 939-8585

2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Phone (925) 939-8585

2625 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 939-8585

350 John Muir Pkwy
Suite 155
Brentwood, CA 94513-5190
Phone (925) 939-8585

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21084CAMDOccupational Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine CurrentSince Nov 1, 2016 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Nov 1, 2016 Accepting new patients
John Muir Health Past Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients
John Muir Health Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients

Locations

101 Sand Creek Rd
#A
Brentwood, CA 94513
Phone (925) 978-6959

350 John Muir Pkwy
Ste 155
Brentwood, CA 94513

1800 Sutter St
Ste 100
Concord, CA 94520
Phone (925) 691-0500

5201 Norris Canyon Rd
Ste 230
San Ramon, CA 94583
Phone (510) 465-5800

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

2625 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 210-8500

Interoperability endpoints

  • Direct secure messaging: ricki.nolley@direct.muirortho.nextgenshare.com

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1578878625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SUTTER ST STE 100",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202530",
            "telephone_number": "925-939-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLLEY",
        "first_name": "RICKI",
        "middle_name": "PAUL",
        "credential": "PA-C, MSPAS, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-13",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "21084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.