Dana Primo, P.A.C.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA11223 Issued in CA

Practice address

880 S Atlantic Blvd
Suite 205
Monterey Park, CA 91754-4700

Phone

(626) 289-0178

Fax

(626) 308-2083

NPI assigned

Jul 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Eastside Orthopedic Medical Associates

  • Specialist
  • Monterey Park, CA
  • NPI 1235210089
  Medicare reassignment

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659396620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 S ATLANTIC BLVD",
            "address_2": "SUITE 205",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544700",
            "telephone_number": "626-289-0178",
            "fax_number": "626-308-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 S ATLANTIC BLVD",
            "address_2": "SUITE 205",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544700",
            "telephone_number": "626-289-0178",
            "fax_number": "626-308-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMO",
        "first_name": "DANA",
        "name_prefix": "Mr.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA11223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "00PA112230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.