NPIMap

Individual provider Active NPI

Mykaela Poe

  • Physician Assistant
  • Larkspur, CA
National Provider Identifier
1861357147
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
67832 Issued in CA
Practice address
5 Bon Air Rd Ste 117
Larkspur, CA 94939-1138
Phone
(415) 448-1500
NPI assigned
Dec 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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 67832 CA Primary

Addresses

Primary practice location

5 Bon Air Rd Ste 117
Larkspur, CA 94939-1138

Mailing address

1319 Washington Ave
PO Box 41
San Leandro, CA 94577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Marin Community Clinic 28 clinicians

Practice addresses (Care Compare)

6090 Redwood Blvd
Suite G
Novato, CA 94945-4569
Phone (415) 448-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
67832CAMDPharmacist

Organizations & group practices 7

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": "1766016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1861357147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1319 WASHINGTON AVE",
            "address_2": "PO BOX 41",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "94577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD STE 117",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391138",
            "telephone_number": "415-448-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "MYKAELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-18",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "67832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larkspur, CA

Sources for this page

Verify at the official NPI Registry.