Individual provider Active NPI

Karen Grace Paolinelli, NP AND PA

  • Physician Assistant
  • Madera, CA
National Provider Identifier
1922097393
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13161 Issued in CA
Practice address
1210 E Almond Ave
Madera, CA 93637-5606
Phone
(559) 675-5530
Fax
(559) 675-5532
NPI assigned
Oct 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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 13161 CA Primary
Family Nurse Practitioner 363LF0000X 411424 CA

Addresses

Primary practice location

1210 E Almond Ave
Madera, CA 93637-5606

Mailing address

510 Woodlands Dr
Madera, CA 93637-5942
Phone (559) 675-5530

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ40408ZOtherCABLUE SHIELD

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
I20040130001095 CA Practitioner - Nurse Practitioner 8426951922 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6136CAMDAcupuncturist
13161CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Valley Endocrinology, a Professional Corporation CurrentSince Feb 7, 2024 Accepting new patients
My Diabetes Tutor Inc PastSince Oct 27, 2019 Accepting new patients

Locations

515 W Grangeville Blvd
Hanford, CA 93230
Phone (559) 587-1100

Organizations & group practices 2

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1922097393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 WOODLANDS DR",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375942",
            "telephone_number": "559-675-5530",
            "fax_number": "559-675-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E ALMOND AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936375606",
            "telephone_number": "559-675-5530",
            "fax_number": "559-675-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLINELLI",
        "first_name": "KAREN",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "NP AND PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "13161",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "411424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ40408Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.