Pamela Wagner

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13893 Issued in CA

Practice address

2900 Chanticleer Ave.
Santa Cruz, CA 95065-1816

Phone

(831) 462-7100

NPI assigned

Jan 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Pamela Voller Former name

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

Specialty

Physician Assistant

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pwagnerarnppac59384@hisp.ehr.sutterhealth.org
• FHIR API: https://api.platform.athenahealth.com/4301/brand/1/csg/1/fhir/r4

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.

• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Surgical Associates of Monterey Bay Medical Corporation

  • Surgery Physician
  • Santa Cruz, CA
  • NPI 1003985037
  NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Santa Cruz Medical Clinic, Inc

  dba Santa Cruz Medical Clinic

  • Family Medicine Physician
  • Santa Cruz, CA
  • NPI 1588775308
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1932179892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE.",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CHANTICLEER AVE.",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651816",
            "telephone_number": "831-462-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "VOLLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karla Wade, BS-CRIMINAL JUSTICE
• Wendy Wade
• David D Wagner, M.D.
• Jesse Wagner
• Jonathon Wagner, DDS
• Gillian Wahleithner, OTR/L, OTD
• Michael Wahlers, M.D.
• Mark Wainer
• Joseph Peter Walencewicz, CMT
• Walgreen Co (Walgreens #03158)

• Physician Assistant in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.