Active NPI
Maria Jeffervescent Matining Caparas, PA-C
- Physician Assistant
- San Diego, CA
National Provider Identifier
1992997217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17154
- Practice address
- 6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715 - Phone
- (480) 307-4693
- NPI assigned
- Aug 10, 2007
- Last updated
- Dec 6, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA3454 | AZ | |
| Physician Assistant | 363A00000X | PA17154 | CA | Primary |
Addresses
Primary practice location
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Mailing address
6195 Lusk Blvd Ste 250
San Diego, CA 92121-3715
Phone (480) 307-4693
Other practice location 1
31565 Rancho Pueblo Rd
Suite 102
Temecula, CA 92592-4839
Phone (951) 303-1701
Other names 1
- Mary Jeffervescent Matining Caparas
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, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4171 Oceanside Blvd
Oceanside, CA 92056-6008
Phone (716) 216-6253
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA3454 | AZ | MD | Physician Assistant |
| PA17154 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul E English MD Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670284800000",
"number": "1992997217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6195 LUSK BLVD STE 250",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213715",
"telephone_number": "480-307-4693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6195 LUSK BLVD STE 250",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213715",
"telephone_number": "480-307-4693"
}
],
"practiceLocations": [
{
"address_1": "31565 Rancho Pueblo Rd",
"address_2": "Suite 102",
"address_purpose": "LOCATION",
"city": "Temecula",
"state": "CA",
"postal_code": "925924839",
"country_code": "US",
"telephone_number": "951-303-1701",
"fax_number": "951-303-1702",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAPARAS",
"first_name": "MARIA JEFFERVESCENT",
"middle_name": "MATINING",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-10",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "PA3454",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY JEFFERVESCENT",
"last_name": "CAPARAS",
"middle_name": "MATINING",
"credential": "PA",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.