Natasha Nicole Witzl, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1501 Superior Ave
Newport Beach, CA 92663-3600

Phone

(949) 642-7600

NPI assigned

Nov 2, 2020

Last updated

Jun 28, 2022By the provider in NPPES

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

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parham Tabibian MD IncGroup PAC ID 9739284704, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: nwitzl@advanceddermcare.emadirect.md

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.

• Parham Tabibian MD Inc

  • Dermatology Physician
  • Los Alamitos, CA
  • NPI 1427114032
  Medicare reassignment Care Compare group
• Parham Tabibian MD Inc

  • Dermatology Physician
  • Agoura Hills, CA
  • NPI 1609343771
  NPD (past)

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1821699380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 ORANGE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633600",
            "telephone_number": "949-642-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITZL",
        "first_name": "NATASHA",
        "middle_name": "NICOLE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2022-06-28",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Wishmyer
• Anaya Lea Wistain
• Heather Witt, PA-C
• Laura Elaine Wittenauer, DDS
• Richard C Wittenauer, D.D.S.
• Mallory Jayne Wofford
• Peter S Wohrle, DMD, M.MED SC
• Michael Jay Wolf, M.D.
• Salina Linda Wolf, M.D.
• Susanna Wolfe, OTR/L

• Physician Assistant in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.