Caroline D Andersen, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21726 Issued in CA

Practice address

415 E Harding Way
Suite D
Stockton, CA 95204-6118

Phone

(209) 944-5750

Fax

(209) 464-2684

NPI assigned

Sep 26, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stockton Cardiology Medical Group Complete Heart Care IncGroup PAC ID 8921048257, 14 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.64 of 100Reported as group

Quality

91.04

Promoting interoperability

74

Improvement activities

40

Cost

73.91

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: candersen136313@hpmg.direct-ci.net

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.

• Stockton Cardiology Medical Group Complete Heart Care Inc

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1477591444

  CA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1669755682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E HARDING WAY",
            "address_2": "SUITE D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046118",
            "telephone_number": "209-944-5750",
            "fax_number": "209-464-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E HARDING WAY",
            "address_2": "SUITE D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046118",
            "telephone_number": "209-944-5750",
            "fax_number": "209-464-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "CAROLINE",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle Renee Anchondo
• Anchor Orthotics and Prosthetics, Inc.
• Anil Andani, MD
• Darell John Andaya
• Andersen Physical Therapy, Inc
• Breanna Anderson
• Cedric Anthony Anderson, MFTI
• David Anderson
• Deshenae Anderson
• Devin Anderson

• All providers in Stockton, CA
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.