Individual provider Active NPI

Itab Ali Nagi

  • Physician Assistant
  • Madera, CA
National Provider Identifier
1699428730
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
62894 Issued in CA
Practice address
1050 E Almond Ave
Madera, CA 93637-5698
Phone
(559) 664-4000
Fax
(559) 675-5224
NPI assigned
Jan 29, 2022
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 62894 CA Primary

Addresses

Primary practice location

1050 E Almond Ave
Madera, CA 93637-5698

Mailing address

1992 N Forestiere Ave
Fresno, CA 93722-8730
Phone (559) 328-7605

Other practice location 1

344 E 6th St
Madera, CA 93638-3631
Phone (559) 664-4000

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
I20230925002930 CA Practitioner - Physician Assistant 0547614547 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62894CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health CurrentSince Aug 30, 2023 Accepting new patients
Camarena Health CurrentSince Aug 30, 2023 Accepting new patients

Locations

344 E 6th St
Madera, CA 93638
Phone (559) 664-4158

505 E Almond Ave
Ste 101
Madera, CA 93637

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

Organizations & group practices 3

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": "1643414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1699428730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1992 N FORESTIERE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937228730",
            "telephone_number": "559-328-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E ALMOND AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375698",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "344 E 6th St",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936383631",
            "country_code": "US",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGI",
        "first_name": "ITAB",
        "middle_name": "ALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-29",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.