Individual provider Active NPI

Isabella Daniels, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1891517157
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
65260 Issued in CA
Practice address
3750 Convoy St Ste 301
San Diego, CA 92111-3741
Phone
(619) 297-4481
NPI assigned
Oct 28, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 65260 CA Primary

Addresses

Primary practice location

3750 Convoy St Ste 301
San Diego, CA 92111-3741

Mailing address

1342 Frankfort St Apt 6302
San Diego, CA 92110-3786
Phone (408) 930-8806

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
I20241119002522 CA Practitioner - Physician Assistant 6103351887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurosurgical Medical Clinic IncGroup PAC ID 3375584287, 10 clinicians

Practice addresses (Care Compare)

3750 Convoy St
San Diego, CA 92111-3741
Phone (619) 297-4481

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 297-4481

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65260CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Trias Global, LLC Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1891517157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 FRANKFORT ST APT 6302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921103786",
            "telephone_number": "408-930-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CONVOY ST STE 301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113741",
            "telephone_number": "619-297-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "ISABELLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.