CARLY AKEMI TAKATA
NPI 1013768217
Physician Assistant in Santa Ana, CA

Q: What is Carly Takata's NPI number?

The NPI number for Carly Takata is 1013768217. It was assigned to this individual provider in the NPPES registry on March 27, 2024.

Q: What is Carly Takata's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Carly Takata was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 27, 2024PECOS EnrolledAccepts Medicare Assignment

5 HUTTON CENTRE DR STE 950, SANTA ANA, CA 92707(855) 434-7763 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 15, 2025, Feb 28, 2025, Apr 14, 2024 (3 updates tracked since 2024).

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About Carly Akemi Takata NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY AKEMI TAKATA (NPI 1013768217) is an individual physician assistant in Santa Ana, California, licensed in California (PA64869) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1013768217

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameCARLY AKEMI TAKATA

Location Address5 HUTTON CENTRE DR STE 950Santa Ana, CA 92707-8744

Mailing Address2603 Bayport DrTorrance, CA 90503-8923

Phone(855) 434-7763

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateMarch 27, 2024

Last NPPES UpdateSeptember 15, 20253 updates tracked since enumeration

NPPES CertifiedSeptember 15, 2025

✔ NPI 1013768217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA64869

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

5 HUTTON CENTRE DR STE 950, Santa Ana, CA 92707

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carly Akemi Takata is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496253809

PECOS Enrollment IDI20250813003091

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92707 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN MARK GEISS D.O.

Family Medicine