Individual provider Active NPI

Annie Kaye Shugarman, P.A.-C

  • Physician Assistant
  • Ladera Ranch, CA
National Provider Identifier
1982701249
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 13421 Issued in CA
Practice address
333 Corporate Dr Ste 200
Ladera Ranch, CA 92694-2179
Phone
(949) 347-7200
Fax
(949) 347-7217
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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 PA 13421 CA Primary

Addresses

Primary practice location

333 Corporate Dr Ste 200
Ladera Ranch, CA 92694-2179

Mailing address

24422 Avenida de la Carlota Ste 300
Laguna Hills, CA 92653-3628
Phone (949) 599-2434

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
I20071231000300 CA Practitioner - Physician Assistant 3779663927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

1125 E 17TH St
Suite W248
Santa Ana, CA 92701-2205
Phone (714) 547-5151

30201 Golden Lantern
Suite B
Laguna Niguel, CA 92677-5926
Phone (949) 363-1788

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 13421CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Nov 12, 2017 Accepting new patients
J Robert West, M.D., Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

30201 Golden Lantern
Ste B
Laguna Niguel, CA 92677
Phone (949) 363-1788

2699 Atlantic Ave
Long Beach, CA 90806
Phone (562) 426-2105

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

1125 E 17th St
Ste W248
Santa Ana, CA 92701
Phone (714) 547-5151

Organizations & group practices 3

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1982701249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24422 AVENIDA DE LA CARLOTA STE 300",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533628",
            "telephone_number": "949-599-2434",
            "fax_number": "949-599-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR STE 200",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942179",
            "telephone_number": "949-347-7200",
            "fax_number": "949-347-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUGARMAN",
        "first_name": "ANNIE",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 13421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

Verify at the official NPI Registry.