Unknown Individual – Medical Physician Assistant, NPI 1124110218

Unknown Individual is a healthcare provider. based in Chico, California. specializing in Medical Physician Assistant. They hold a License No. PA 14464 (CA). The NPI Number for Unknown Individual is 1124110218

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1124110218
Phone
(530) 898-1105
Address
145 MISSION RANCH BLVD
Deactivation Date
29 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5303327300
Graduation Year
1997 (29 years ago)
PAC ID
9739282427
Group Practice PAC ID
9739092388
Professional Enrollment ID
I20070319000241
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 145, Mission Ranch Boulevard, Chico, Butte County, California, 95926, United States

    STE. 115

    CHICO, CA 959262175

    Phone: (530) 898-1105

    Fax: (530) 894-5796

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 95926)

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Provider's Procedures

Unknown Individual performs procedures in Medical Physician Assistant. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTCA81002Urinalysis, manual test5842

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739092388View full group profile
NameSpecialtyState
DANIEL M BAKER (M.D.)
Diagnostic RadiologyOH
DR. RICHARD CARREGAL (D.O.)
Diagnostic RadiologyTX
TODD GREENBERG (MD)
Diagnostic RadiologyME
BRITTANY O'REGAN
Physician AssistantCA
DR. MAURICE VALCARENGHI (MD)
-CA
FRANCES P KATRIS (M.D.)
Emergency MedicineCA
DR. AKIBA EDO GREEN (DO)
-CA
MAYA LOUISE SAAKE ARMENTA (MSN, NP)
Nurse PractitionerCA
DR. MICHAELA SHEPPHARD (M.D.)
Emergency MedicineCA
CHERYL A STRUVE (CNM)
-CA

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1124110218 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in California is Unknown Individual registered?
Use Chico, California as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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