Individual provider Active NPI

Robin Faith Fraser, PA-C

  • Physician Assistant
  • Eureka, CA
National Provider Identifier
1760892285
Registry record updated Aug 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
51578 Issued in CA
Practice address
2675 Harris St
Eureka, CA 95503-4806
Phone
(707) 443-8335
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2015

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 51578 CA Primary

Addresses

Primary practice location

2675 Harris St
Eureka, CA 95503-4806

Mailing address

2675 Harris St
Eureka, CA 95503-4806
Phone (707) 443-8335

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
I20140919000118 CA Practitioner - Physician Assistant 3971722299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

200 W Ctr St Promenade
Anaheim, CA 92805-3960

2321 Harrison Ave
Suite S
Eureka, CA 95501-3216
Phone (707) 445-3674

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Mad River Community Hospital Hospital, Arcata, CA, CCN 050028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51578CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince May 1, 2017 Accepting new patients
Providence Medical Foundation CurrentSince May 1, 2017 Accepting new patients
Humboldt Medical Specialists, Inc Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

2280 Harrison Ave
Ste K
Eureka, CA 95501
Phone (707) 443-9371

2675 Harris St
Eureka, CA 95503
Phone (707) 269-0644

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: rfraser1648022@oc.providencedirect.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439078400000",
    "number": "1760892285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034806",
            "telephone_number": "707-443-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034806",
            "telephone_number": "707-443-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRASER",
        "first_name": "ROBIN",
        "middle_name": "FAITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2015-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.