Active NPI
Anina Dee Bacon, PA-C
- Medical Physician Assistant
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA.PA.60357177
- Practice address
- 2823 Fresno St
Fresno, CA 93721-1324 - Phone
- (559) 443-2682
- Fax
- (559) 443-2681
- NPI assigned
- Oct 14, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA.PA.60357177 | WA | Primary |
Addresses
Primary practice location
2823 Fresno St
Fresno, CA 93721-1324
Mailing address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2034718 | Medicaid | WA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/ | Other | |
| Direct Messaging Address | abacon56098@direct.valleymed.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210
1476 Professional Dr
Suite 504
Petaluma, CA 94954-1500
Phone (707) 781-7350
200 W Ctr St Promenade
Anaheim, CA 92805-3960
500 Doyle Park Dr
Santa Rosa, CA 95405-4559
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60979 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients |
Locations
1476 Professional Dr
Ste 504
Petaluma, CA 94954
Phone (707) 762-0729
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- Surgery Physician
- Eureka, CA
- NPI 1477790517
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
dba Providence Santa Rosa Memorial Hospital
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1134152549
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mendocino Coast District Hospital
- Critical Access Hospital
- Fort Bragg, CA
- NPI 1538113725
-
dba Petaluma Valley Hospital
- General Acute Care Hospital
- Petaluma, CA
- NPI 1235162645
-
dba Providence Santa Rosa Memorial Hospital
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1134152549
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1952739708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 116TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980044604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2823 FRESNO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211324",
"telephone_number": "559-443-2682",
"fax_number": "559-443-2681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACON",
"first_name": "ANINA",
"middle_name": "DEE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-14",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA.PA.60357177",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2034718",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://FHIR.valleymed.org/FHIR-PRD/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "4011 Talbot Rd S Ste 460",
"city": "Renton",
"state": "WA",
"country_code": "US",
"postal_code": "980555791",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "abacon56098@direct.valleymed.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "abacon56098@direct.valleymed.org",
"address_1": "4011 Talbot Rd S Ste 460",
"city": "Renton",
"state": "WA",
"country_code": "US",
"postal_code": "980555791",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.