Individual provider Active NPI

Cynthia Maureen Hale, PA

  • Physician Assistant
  • Chico, CA
National Provider Identifier
1902092786
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15263 Issued in CA
Practice address
145 Mission Ranch Blvd.
Suite 110
Chico, CA 95926
Phone
(530) 896-2200
Fax
(530) 896-2209
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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 PA15263 CA Primary

Addresses

Primary practice location

145 Mission Ranch Blvd.
Suite 110
Chico, CA 95926

Mailing address

145 Mission Ranch Blvd.
Suite 110
Chico, CA 95926
Phone (530) 896-2200

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
I20110315000432 CA Practitioner - Physician Assistant 3870775695 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Enloe Medical Center CurrentSince May 1, 2021 Accepting new patients
Enloe Medical Center CurrentSince May 1, 2021 Accepting new patients
Gary Incaudo M D Inc Past Accepting new patients

Locations

111 Raley Blvd
Ste 100
Chico, CA 95928
Phone (530) 332-3986

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1902092786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MISSION RANCH BLVD.",
            "address_2": "SUITE 110",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95926",
            "telephone_number": "530-896-2200",
            "fax_number": "530-896-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MISSION RANCH BLVD.",
            "address_2": "SUITE 110",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "95926",
            "telephone_number": "530-896-2200",
            "fax_number": "530-896-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "CYNTHIA",
        "middle_name": "MAUREEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.