Angela Wyble, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17243 Issued in CA

Practice address

2725 Mendocino Ave
Santa Rosa, CA 95403-2805

Phone

(707) 545-4537

Fax

(707) 545-6726

NPI assigned

Sep 16, 2005

Last updated

Apr 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

92.97 of 100Reported as group

Quality

100

Improvement activities

40

Cost

76.57

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Redwood Dermatopathology Laboratory

  • Clinical Medical Laboratory
  • Santa Rosa, CA
  • NPI 1588879373
  NPD (past)

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1871588715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 MENDOCINO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032805",
            "telephone_number": "707-545-4537",
            "fax_number": "707-545-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 MENDOCINO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032805",
            "telephone_number": "707-545-4537",
            "fax_number": "707-545-6726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2959 Siskiyou Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048131",
            "country_code": "US",
            "telephone_number": "541-773-3636 x1011",
            "fax_number": "541-773-4643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYBLE",
        "first_name": "ANGELA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wei Der Wu, M.D.
• Sophia Rose Wuest
• Heidi Wurzburg, RN, MSN, FNP
• Wyatt Dental Corporation
• Cherylin H Wyatt, DDS
• Ashleigh Wylie
• Catherine Wynia, M.A.
• Jeffrey Y Xu, MD
• Songyi Xu, PHARMD
• Shalini Yalamanchi, MD

• Medical Physician Assistant in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.