Carolyn L Arellanes, PA
Individual provider Active NPI Physician Assistant · Smith River, CA
NPI 1659501880 · NPPES record last updated May 3, 2023
Key facts
- NPI
- 1659501880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA20429 (CA)
- Practice address
- 501 N Indian Rd
Smith River, CA 95567-9509 - Phone
- (707) 487-0215
- Fax
- (707) 487-3003
- NPI assigned
- Jul 22, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of California, Davis School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- United Indian Health Services, Inc.
Practice addresses (Care Compare)
1600 Weeot Way
Arcata, CA 95521-4734
Phone (707) 825-5000
501 N Indian Rd
Smith River, CA 95567-9509
Phone (707) 487-0215
Hospital & facility affiliations
- Sutter Coast Home Care
- Sutter Coast Hospital
- Curry General Hospital
- Providence St Joseph Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091007000723 | CA | Practitioner - Physician Assistant | 7810033651 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20429 | CA | MD | Acupuncturist |
| PA20429 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Door Community Health Centers | Current |
Accepting new patients | |
| United Indian Health Services, Inc. | Current |
Accepting new patients | |
| United Indian Health Services, Inc. | Current |
Accepting new patients | |
| Open Door Community Health Centers | Current |
Accepting new patients | |
| United Indian Health Services, Inc. | Past | Accepting new patients | |
| United Indian Health Services, Inc. | Past | Accepting new patients |
Locations
1275 8th St
Arcata, CA 95521
1600 Weeot Way
Arcata, CA 95521
Phone (707) 825-5000
550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636
1675 Northcrest Dr
Crescent City, CA 95531
Phone (707) 464-2750
501 N Indian Rd
Smith River, CA 95567
Phone (707) 487-0215
Interoperability endpoints
- carellanes813477@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA20429 | CA | Yes |
Addresses
Primary practice location
501 N Indian Rd
Smith River, CA 95567-9509
Mailing address
1600 Weeot Way
Arcata, CA 95521-4734
Phone (707) 825-5000
Other practice location 1
1675 Northcrest Dr
Crescent City, CA 95531-8928
Phone (707) 464-2750
Other practice location 2
1600 Weeot Way
Arcata, CA 95521-4734
Phone (707) 825-5000
Other names
- Carolyn Dikes
Other providers in Smith River, CA
All providers in Smith River, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.