Individual provider Active NPI

Asia Mei Stautz

  • Physician Assistant
  • San Rafael, CA
National Provider Identifier
1609653971
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
50 Acacia Ave
San Rafael, CA 94901-2230
Phone
(415) 457-4440
NPI assigned
Sep 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

50 Acacia Ave
San Rafael, CA 94901-2230

Mailing address

50 Acacia Ave
San Rafael, CA 94901-2230

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
I20250804001971 CA Practitioner - Physician Assistant 7719495456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

609 Deep Valley Dr
FL 2
Rolling Hills Estates, CA 90274-3614

609 Deep Valley Dr FL
Suite 2
Rolling Hills Estates, CA 90274-3629

National Provider Directory

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

Organizations & group practices 1

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": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1609653971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ACACIA AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ACACIA AVE",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012230",
            "telephone_number": "415-457-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUTZ",
        "first_name": "ASIA",
        "middle_name": "MEI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.