Individual provider Active NPI

Marie A. Demasi, PAC

  • Physician Assistant
  • Oakhurst, CA
National Provider Identifier
1689833675
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.19592 Issued in CA
Practice address
40232 Junction Drive
Oakhurst, CA 93644
Phone
(559) 658-6420
Fax
(559) 658-6460
NPI assigned
Jun 4, 2008
Last updated
Oct 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.19592 CA Primary
Medical Physician Assistant 363AM0700X PA 19592 CA

Addresses

Primary practice location

40232 Junction Drive
Oakhurst, CA 93644

Mailing address

P.O Box 28949
Fresno, CA 93728-8924
Phone (559) 258-4311

Other identifiers 3

IdentifierTypeStateIssuer
L618MedicaidCA
PA 19592OtherCACA LICENSE
15-01530OtherKSKS LICENSE

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
I20120412000510 CA Practitioner - Physician Assistant 3577724830 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19592CAMDFamily Medicine Physician
PA.19592CAMDPhysician Assistant
PA 19592CAMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1689833675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 28949",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937288924",
            "telephone_number": "559-258-4311",
            "fax_number": "559-224-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40232 JUNCTION DRIVE",
            "city": "OAKHURST",
            "state": "CA",
            "postal_code": "93644",
            "telephone_number": "559-658-6420",
            "fax_number": "559-658-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMASI",
        "first_name": "MARIE",
        "middle_name": "A.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA.19592",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 19592",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L618",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "PA 19592",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KS LICENSE",
            "identifier": "15-01530",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakhurst, CA

Sources for this page

Verify at the official NPI Registry.