Individual provider Active NPI

Catherine Jeter, PA-C

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1881152775
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60561 Issued in CA
Practice address
16300 Sand Canyon Ave Ste 612
Irvine, CA 92618-3706
Phone
(949) 753-1001
NPI assigned
Mar 9, 2019
Last updated
Feb 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60561 CA Primary
Dermatology Physician 207N00000X PA60561 CA

Addresses

Primary practice location

16300 Sand Canyon Ave Ste 612
Irvine, CA 92618-3706

Mailing address

16300 Sand Canyon Ave Ste 612
Irvine, CA 92618-3706
Phone (949) 753-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241206001113 TX Practitioner - Physician Assistant 9537576269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpesh D. Desai, DO, PAGroup PAC ID 8426055625, 27 clinicians

Practice addresses (Care Compare)

8203 Willow Place Dr S
165 Houston Willow PL
Houston, TX 77070-5526
Phone (832) 604-7400

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60561CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Fein PC Dermatology PastSince Nov 1, 2025 Accepting new patients
Los Angeles ENT Facial Plastics Center, Inc Past Accepting new patients
Palos Verdes Skin Surgery Ctr Inc Past Accepting new patients
Heights Dermatology - Willowbrook, PLLC Dermatology PastSince May 1, 2016 Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1881152775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE STE 612",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183706",
            "telephone_number": "949-753-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 SAND CANYON AVE STE 612",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183706",
            "telephone_number": "949-753-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-09",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60561",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "PA60561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.