Individual provider Active NPI

Valerie Venghiattis, PA

  • Physician Assistant
  • Woodland, CA
National Provider Identifier
1689662801
Registry record updated Feb 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
20116 Issued in CA
Practice address
2081 Bronze Star Dr
Woodland, CA 95776-5423
Phone
(530) 668-2600
Fax
(530) 661-1081
NPI assigned
Oct 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1386 CO
Physician Assistant 363A00000X 20116 CA Primary

Addresses

Primary practice location

2081 Bronze Star Dr
Woodland, CA 95776-5423

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171205002629 CA Practitioner - Physician Assistant 0244233658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northbay Health Medical FoundationGroup PAC ID 3274010871, 207 clinicians

Practice addresses (Care Compare)

1320 Travis Blvd
C
Fairfield, CA 94533-4654
Phone (707) 646-4000

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20116CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Nov 1, 2017 Accepting new patients
Northbay Health Medical Foundation CurrentSince Jan 1, 2026 Accepting new patients
Clinica Campesina Family Health Services Past Accepting new patients

Locations

1305 Stratford Ave
Dixon, CA 95620

1320 Travis Blvd
#C
Fairfield, CA 94533
Phone (707) 646-4000

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1010 Nut Tree Rd
Ste 100B
Vacaville, CA 95687
Phone (707) 646-7999

101 Main St
Winters, CA 95694
Phone (530) 795-4123

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580774400000",
    "number": "1689662801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 BRONZE STAR DR",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957765423",
            "telephone_number": "530-668-2600",
            "fax_number": "530-661-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENGHIATTIS",
        "first_name": "VALERIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "1386",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.