Individual provider Active NPI

Caitlin Grace Garrison, PA-C

  • Physician Assistant
  • Huntington Beach, CA
National Provider Identifier
1710237011
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
22448 Issued in CA
Practice address
4911 Warner Ave Ste 205
Huntington Beach, CA 92649-4473
Phone
(714) 316-0611
Fax
(714) 520-0087
NPI assigned
Sep 13, 2012
Last updated
Apr 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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 22448 CA Primary

Addresses

Primary practice location

4911 Warner Ave Ste 205
Huntington Beach, CA 92649-4473

Mailing address

4911 Warner Ave Ste 205
Huntington Beach, CA 92649-4473
Phone (714) 316-0611

Other practice location 1

8787 Hall Rd
Lamont, CA 93241
Phone (661) 845-3688

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
I20121015000111 CA Practitioner - Physician Assistant 6103075890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
D E Garrison DO IncGroup PAC ID 4981009974, 3 clinicians

Practice addresses (Care Compare)

4911 Warner Ave
Suite 205
Huntington Beach, CA 92649-4473
Phone (714) 316-0611

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph F Chow M.D., Inc. PastSince Jan 13, 2010 Accepting new patients
Coastal Communities Physician Network, Inc. Past Accepting new patients
James T Wang MD Inc PastSince Dec 1, 2003 Accepting new patients

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, 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": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1710237011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 WARNER AVE STE 205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926494473",
            "telephone_number": "714-316-0611",
            "fax_number": "714-520-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 WARNER AVE STE 205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926494473",
            "telephone_number": "714-316-0611",
            "fax_number": "714-520-0087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8787 Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Lamont",
            "state": "CA",
            "postal_code": "93241",
            "country_code": "US",
            "telephone_number": "661-845-3688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "CAITLIN",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "22448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.