MRS. TRACY MELINDA ARSENAULT (NPI# 1497056824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497056824 |
| Entity Type | Individual |
| Full Name | MRS. TRACY MELINDA ARSENAULT |
| Credential | PA-C |
| Practice Address |
4980 Barranca Pkwy Suite 200 Irvine CA 92604-8645 |
| Practice Telephone | 9497865050 |
| Mailing Telephone | 9497865050 |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2014-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085-003952 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10001255A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2708-023 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
085-003952 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUECROSS BLUESHIELD | 01618941 | 01 |
| Street Address |
4980 BARRANCA PKWY SUITE 200 |
| City | IRVINE |
| State | CA |
| Zip Code | 92604-8645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528041704 | Bruce M Albert | Orthopaedic Surgery | 4980 Barranca Pkwy, Suite 201, Irvine, CA 92604-8645 | 2005-11-22 |
| 1679993091 | Matthew C Tsai Dds Inc | Clinic/Center | 4980 Barranca Pkwy, #204, Irvine, CA 92604-8645 | 2014-04-24 |
| 1285070466 | Tsai, Hsiao & Loo Dental Corporation | Dentist | 4980 Barranca Pkwy, Suite 204, Irvine, CA 92604-8645 | 2013-05-15 |
| 1104170323 | Laura Kay Villasenor | Nurse Practitioner | 4980 Barranca Pkwy, Suite 200, Irvine, CA 92604-8645 | 2012-11-09 |
| 1790045300 | Zain Vally Md Inc A Professional Corporation | Internal Medicine | 4980 Barranca Pkwy, Suite 195, Irvine, CA 92604 | 2012-05-17 |
| 1962769729 | The Spine and Pain Center of Orange County | Internal Medicine | 4980 Barranca Pkwy, Suite 195, Irvine, CA 92604-8645 | 2012-04-18 |
| 1831465798 | Minkyung Jung | Acupuncturist | 4980 Barranca Pkwy, #130, Irvine, CA 92604-8645 | 2012-03-26 |
| 1710251764 | Badii Lee Dental Corporation, Inc | Dentist | 4980 Barranca Pkwy, Suite 101, Irvine, CA 92604-8645 | 2012-03-07 |
| 1538459979 | Mspt Inc | Physical Therapist | 4980 Barranca Pkwy, Suite 195, Irvine, CA 92604-8645 | 2011-04-18 |
| 1639485303 | Mary M Jew | Dentist | 4980 Barranca Pkwy, Suite 150, Irvine, CA 92604-8645 | 2010-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417643 | New Skin and Body Aesthetics Inc | Internal Medicine | 4980 Barranca Parkway, 201, Irvine, CA 92604 | 2020-11-02 |
| 1679091144 | Alan Chang | Pharmacist | 5385 Alton Parkway, Irvine, CA 92604 | 2017-09-06 |
| 1942751599 | Haleh Ranjijifroody | Chiropractor | 4980 Barranca Parkway Unit 200, Irvine, CA 92604 | 2016-10-19 |
| 1265982136 | Nora M Balke | Nurse Practitioner | 4968 Booth Cir Ste 110, Irvine, CA 92604 | 2016-10-04 |
| 1679945612 | Cvs Pharmacy | Pharmacist | 15333 Culver Drive, Suite 300, Irvine, CA 92604 | 2015-10-29 |
| 1184016230 | Keri Blasingame | Nurse Practitioner | 4980 Barranca Parkway Suite 200, Irvine, CA 92604 | 2015-02-26 |
| 1679979827 | Oc Women's Health,apc | Obstetrics & Gynecology | 14252 Culver Drive Suite A 499, Irvine, CA 92604 | 2014-11-17 |
| 1326443920 | Peter Sumarsono Professional Dental Corporation | Preferred Provider Organization | 4605 Barranca Parkway., 200, Irvine, CA 92604 | 2014-10-27 |
| 1164832218 | Abdiel Noe Hernandez | Driver | 14252 Culver Drive Ste A, Irvine, CA 92604 | 2014-04-29 |
| 1811315781 | Trisha Sharma | Internal Medicine | 6 Willard St, Kaiser Permanente- Barranca Medical Office Building, Irvine, CA 92604 | 2014-03-28 |
| Find all providers in zip 92604 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891932950 | Derrick Stephan | Physician Assistant | 211 Rhythm, Irvine, CA 92603-4254 | 2009-01-12 |
| 1134537871 | Beatriz Simons | Physician Assistant | 6670 Alton Pkwy, Irvine, CA 92618-3734 | 2014-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894403 | Kathlyn Larco | Physician Assistant | 1233 W Randall Way, West Covina, CA 91790-4747 | 2020-06-07 |
| 1487126421 | Eliza Hughes | Physician Assistant | 860 Oak Park Blvd Ste 101, Arroyo Grande, CA 93420-1800 | 2018-12-31 |
| 1508333873 | Andrew Cantos Malit | Physician Assistant | 409 Bristol Way, Corona, CA 92879-6156 | 2018-10-25 |
| 1578049458 | Ida Jelveh | Physician Assistant | 28096 Edelweiss Ct, Laguna Niguel, CA 92677-7006 | 2018-07-13 |
| 1356833578 | Michael James Gonzalez | Physician Assistant | 1500 E Chevy Chase Dr # 401a401b, Glendale, CA 91206-4152 | 2018-06-04 |
| 1023500592 | Pamela Lambert Pa-c, Inc. | Physician Assistant | 16105 Mariposa Ave, Riverside, CA 92504-8730 | 2018-05-31 |
| 1225532385 | Folsom Physicain Assistant First Assist, Inc | Physician Assistant | Nina Vasiliev Pa-c, 15407 Muller Rd, Plymouth, CA 95669-9770 | 2018-03-22 |
| 1275040008 | Gm Surgical Assistant Inc | Physician Assistant | 15615 Turnberry St, Moreno Valley, CA 92555-4901 | 2018-01-02 |
| 1902311186 | Or Solutions Inc | Physician Assistant | 1501 Secret Ravine Pkwy Unit 527, Roseville, CA 95661-6005 | 2017-12-09 |
| 1184143828 | Alaa Abdalla Daghlas | Physician Assistant | 1100 S Eliseo Dr Ste A, Greenbrae, CA 94904-2017 | 2017-09-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.