Individual provider Active NPI

Mary Gausepohl, PA-C

  • Medical Physician Assistant
  • Murrieta, CA
National Provider Identifier
1841362837
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
24910 Las Brisas Rd Ste 105
Murrieta, CA 92562-4010
Phone
(951) 231-1385
Fax
(951) 461-9191
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

24910 Las Brisas Rd Ste 105
Murrieta, CA 92562-4010

Mailing address

24910 Las Brisas Rd Ste 105
Murrieta, CA 92562-4010
Phone (951) 231-1385

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
I20160310000741 CA Order and Referring Only - Physician Assistant 5991706558

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18611CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Healthcare System, L.P. Past Accepting new patients
All Family Healthcare Corp Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mary.gausepohl.1@3408.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3408/brand/2/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1841362837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD STE 105",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624010",
            "telephone_number": "951-231-1385",
            "fax_number": "951-461-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24910 LAS BRISAS RD STE 105",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925624010",
            "telephone_number": "951-231-1385",
            "fax_number": "951-461-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUSEPOHL",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.