Individual provider Active NPI

Emeri Palacio

  • Physician Assistant
  • Seaside, CA
National Provider Identifier
1972294098
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64097 Issued in CA
Practice address
1513 Fremont Blvd Ste E1
Seaside, CA 93955-4319
Phone
(831) 899-1910
NPI assigned
May 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 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 64097 CA Primary

Addresses

Primary practice location

1513 Fremont Blvd Ste E1
Seaside, CA 93955-4319

Mailing address

100 Wilson Rd Ste 100
Monterey, CA 93940-7885
Phone (831) 649-1000

Other practice location 1

3100 Telegraph Ave
Oakland, CA 94609-3239
Phone (800) 607-6377

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
I20240506003793 CA Practitioner - Physician Assistant 5890135925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors on Duty Medical Group, IncGroup PAC ID 2466366703, 64 clinicians

Practice addresses (Care Compare)

3130 Del Monte Blvd
Marina, CA 93933-3047
Phone (831) 883-3330

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64097CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seaside Doctors on Duty PastSince Apr 14, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: epalacio19264@direct.svmh.com

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": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1972294098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSON RD STE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407885",
            "telephone_number": "831-649-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 FREMONT BLVD STE E1",
            "city": "SEASIDE",
            "state": "CA",
            "postal_code": "939554319",
            "telephone_number": "831-899-1910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Telegraph Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946093239",
            "country_code": "US",
            "telephone_number": "800-607-6377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALACIO",
        "first_name": "EMERI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaside, CA

Sources for this page

Verify at the official NPI Registry.