Mariam Seda Walters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA21183 Issued in CA

Practice address

1798 N Garey Ave
Pomona, CA 91767-2918

Phone

(909) 865-9828

NPI assigned

Sep 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carbon Health Medical Group of California PCGroup PAC ID 9032340047, 335 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.69 of 100Reported as group

Quality

90

Improvement activities

40

Cost

78.43

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Carbon Health Medical Group of California PC

  dba Carbon Health

  • Urgent Care Clinic/Center
  • Berkeley, CA
  • NPI 1417294232
  Medicare reassignment Care Compare group
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment
• Carbon Health Medical Group of California PC

  dba Carbon Health

  • Urgent Care Clinic/Center
  • Pasadena, CA
  • NPI 1255957205
  NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Walnut Creek, CA
  • NPI 1407886138
  NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Pomona, CA
  • NPI 1740235258
  NPD
• Emergency Medicine Physician Partners of San Bernardino County, Inc

  • Emergency Medicine Physician
  • San Bernardino, CA
  • NPI 1225339294
  NPD (past)

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1699083675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10855 TERRA VISTA PKWY",
            "address_2": "APT 111",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306381",
            "telephone_number": "310-729-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1798 N GAREY AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672918",
            "telephone_number": "909-865-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "MARIAM",
        "middle_name": "SEDA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA  LICENSE NUMBER",
            "identifier": "PA21183",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc. (Walmart Pharmacy 10-2288)
• Walmart, Inc. (Walmart pharmacy 10-3164)
• Kennedy Walpus
• April Marion Walters
• Ashlee Rae Walters
• Monika Stephanie Wan, PHARMD
• Wang Integrative Rehabilitation, Inc.
• Derek J.S. Wang
• Geena Wang
• Leeann Linda Wang

• Physician Assistant in Pomona, CA
• Providers in Pomona, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.