Desirae Nicole Macias, P.A

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA52952 Issued in CA

Practice address

4911 Warner Ave Suite 205
Huntington Beach, CA 92649

Phone

(714) 316-0611

Fax

(714) 520-0087

NPI assigned

Oct 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other names 1

• Desirae Nicole Gardiner Former name

Medicare fee-for-service enrollment

Enrolled in CA, CO, FL, AZ, NV, NM6 enrollments

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 6

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians

Health Diagnostics of California a Professional CorporationGroup PAC ID 4284621525, 176 clinicians

Simonmed Imaging Florida LLCGroup PAC ID 6608036108, 302 clinicians

D E Garrison DO IncGroup PAC ID 4981009974, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.3 of 100Reported as group

Quality

75.71

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Health Diagnostics of California a Professional Corporation

  • Diagnostic Radiology Physician
  • Mountain View, CA
  • NPI 1104321959
  Medicare reassignment Care Compare group NPD
• Simonmed Imaging Florida LLC

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1477830818

  CA

  Medicare reassignment Care Compare group NPD
• D E Garrison DO Inc

  • Family Medicine Physician
  • Huntington Beach, CA
  • NPI 1811517832
  Medicare reassignment Care Compare group
• Smi Imaging, LLC

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489

  CA, CO, NV

  Medicare reassignment Care Compare group
• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment NPD
• Simonmed Reno PLLC

  • Diagnostic Radiology Physician
  • Reno, NV
  • NPI 1306576145

  CA

  Medicare reassignment NPD
• Advanced Dermatology Care Center Inc

  • Dermatology Physician
  • Huntington Beach, CA
  • NPI 1114971975
  Medicare reassignment
• Agape Dermatology PC

  • Dermatology Physician
  • Huntington Beach, CA
  • NPI 1073152112
  Medicare reassignment
• Telehealth Specialty Medical Group

  • Emergency Medicine Physician
  • Roseville, CA
  • NPI 1326338237
  Medicare reassignment
• Howard John Simon MD PC

  • Diagnostic Radiology Physician
  • New York, NY
  • NPI 1932768934

  CA

  Medicare reassignment
• Health Diagnostics of California a Professional Corporation

  • Diagnostic Radiology Physician
  • Laguna Hills, CA
  • NPI 1245861368
  NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1851763676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 WARNER AVE SUITE 205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92649",
            "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 SUITE 205",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92649",
            "telephone_number": "714-316-0611",
            "fax_number": "714-520-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIAS",
        "first_name": "DESIRAE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "285",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028264-01",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10772",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA3264",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119701",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52952",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA52952",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0008942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIRAE",
            "last_name": "GARDINER",
            "middle_name": "NICOLE",
            "credential": "P.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Celine Macdonald, MS, BCBA
• Laura Macdonald
• Robert James Macdonald II, DR. PHYSICAL THERAPY
• Daisy Macedo, PPS
• Kerri Mach
• Steven Macina, DO
• Lanita Mack, DPT
• Kristin Mackay
• Cleve S Mackenzie, MD
• Jorrie Stuart Mackenzie, PH.D.

• Physician Assistant in Huntington Beach, CA
• Providers in Huntington 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 Oct 15, 2025; 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.