NPIMap

Individual provider Active NPI

Carolyn L Arellanes, PA

  • Physician Assistant
  • Smith River, CA
National Provider Identifier
1659501880
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20429 Issued in 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
Last updated
May 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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 PA20429 CA Primary

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 1

  • Carolyn Dikes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091007000723 CA Practitioner - Physician Assistant 7810033651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA20429CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Indian Health Services, Inc. CurrentSince Jun 1, 2014 Accepting new patients
Open Door Community Health Centers CurrentSince Jul 13, 2009 Accepting new patients
United Indian Health Services, Inc. CurrentSince Jun 1, 2014 Accepting new patients
Open Door Community Health Centers CurrentSince Jul 13, 2009 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

1675 Northcrest Dr
Crescent City, CA 95531
Phone (707) 464-2750

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636

501 N Indian Rd
Smith River, CA 95567
Phone (707) 487-0215

Interoperability endpoints

  • Direct secure messaging: carellanes813477@direct.ochin.org

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1659501880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WEEOT WAY",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214734",
            "telephone_number": "707-825-5000",
            "fax_number": "707-825-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N INDIAN RD",
            "city": "SMITH RIVER",
            "state": "CA",
            "postal_code": "955679509",
            "telephone_number": "707-487-0215",
            "fax_number": "707-487-3003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Northcrest Dr",
            "address_purpose": "LOCATION",
            "city": "Crescent City",
            "state": "CA",
            "postal_code": "955318928",
            "country_code": "US",
            "telephone_number": "707-464-2750",
            "fax_number": "707-464-2668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Weeot Way",
            "address_purpose": "LOCATION",
            "city": "Arcata",
            "state": "CA",
            "postal_code": "955214734",
            "country_code": "US",
            "telephone_number": "707-825-5000",
            "fax_number": "707-825-6747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARELLANES",
        "first_name": "CAROLYN",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "DIKES",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Smith River, CA

Sources for this page

Verify at the official NPI Registry.