Individual provider Active NPI

Maia Nicole Dinglasan, PA-C

  • Surgical Physician Assistant
  • San Francisco, CA
National Provider Identifier
1649945064
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
490 Post St Ste 530
San Francisco, CA 94102-1412
Phone
(000) 000-0000
NPI assigned
Aug 9, 2021
Reactivated
Oct 20, 2021
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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 Primary

Addresses

Primary practice location

490 Post St Ste 530
San Francisco, CA 94102-1412

Mailing address

1811 Welford LN
Hayward, CA 94544-6798

Other practice location 1

1811 Welford Ln
Hayward, CA 94544-6798
Phone (209) 969-5716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60344CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21166/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1649945064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 WELFORD LN",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945446798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 POST ST STE 530",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021412",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 Welford Ln",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945446798",
            "country_code": "US",
            "telephone_number": "209-969-5716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DINGLASAN",
        "first_name": "MAIA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "deactivation_date": "2021-09-30",
        "reactivation_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.