Individual provider Active NPI

Anna Marie Lubatti, P.A-C

  • Physician Assistant
  • Colton, CA
National Provider Identifier
1598708661
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15540 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1410
NPI assigned
Jun 14, 2006
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 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 PA15540 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

2100 Powell St
Ste 920
Emeryville, CA 94608-1826
Phone (510) 350-2777

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20080510000137 CA Practitioner - Physician Assistant 5890874192 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15540CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Urgent Care Group, Inc CurrentSince Sep 4, 2012 Accepting new patients
Cep America-California CurrentSince Jul 1, 2010 Accepting new patients
Cep America - California CurrentSince Apr 10, 2006 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 6, 2010 Accepting new patients
Cep America-California CurrentSince Apr 10, 2006 Accepting new patients
Cep America - California Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

12442 Limonite Ave
Unit 102
Eastvale, CA 91752
Phone (951) 393-3000

16465 Sierra Lakes Pkwy
Ste 100
Fontana, CA 92336
Phone (909) 434-1150

9920 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 236-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

1805 Medical Center Dr
#P
Sn Bernrdno, CA 92411
Phone (909) 887-6333

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18095/brand/2/csg/1/fhir/r4

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1598708661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBATTI",
        "first_name": "ANNA MARIE",
        "name_prefix": "Miss",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.