Individual provider Active NPI

Audrey Chen

  • Physician Assistant
  • Santa Maria, CA
National Provider Identifier
1902637879
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023
Phone
(805) 621-7714
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 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 Primary

Addresses

Primary practice location

1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023

Mailing address

1075 E Betteravia Rd Ste 201
Santa Maria, CA 93454-7023

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
I20241118002291 CA Practitioner - Physician Assistant 2365976040 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65273CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. Emergency Medicine CurrentSince Jan 6, 2025 Accepting new patients
Central California Faculty Medical Group, Inc. Emergency Medicine CurrentSince Jan 6, 2025 Accepting new patients
Central California Faculty Medical Group, Inc. CurrentSince Jan 6, 2025 Accepting new patients

Locations

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

Interoperability endpoints

  • Direct secure messaging: audrey.chen.1@18628.direct.athenahealth.com

Organizations & group practices 4

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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1902637879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 E BETTERAVIA RD STE 201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 E BETTERAVIA RD STE 201",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934547023",
            "telephone_number": "805-621-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.