1. Home
  2. Directory
  3. California
  4. Fremont
  5. Physician Assistant
  6. NPI Profile

ANNISA NABILA SOEBOER PA-C
NPI 1053985929
Physician Assistant in Fremont, CA

Active since May 16, 2021PECOS EnrolledAccepts Medicare Assignment
87.11/100
CMS Quality Rating
2000 MOWRY AVE, FREMONT, CA 94538(707) 771-5687 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Sep 30, 2022, May 16, 2021 (3 updates tracked since 2021).

About Annisa Nabila Soeboer Pa-c NPPES

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

ANNISA NABILA SOEBOER PA-C (NPI 1053985929) is an individual physician assistant in Fremont, California and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS and is a graduate of Touro Un College Of Osteopathic Medicine, Vallejo (2022).

NPPES Registry Identity

NPI1053985929
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameANNISA NABILA SOEBOERCredential: PA-C
Location Address2000 MOWRY AVEFremont, CA 94538-1716
Mailing Address2000 Mowry AveFremont, CA 94538-1716
Phone(707) 771-5687
Sole ProprietorNo
Medical School CMSTouro Un College Of Osteopathic Medicine, VallejoGraduated 2022
Enumeration DateMay 16, 2021
Last NPPES UpdateMarch 7, 20233 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2022
✔ NPI 1053985929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
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.
2000 MOWRY AVE, Fremont, CA 94538
Open in Google Maps ↗

Other Identifiers 1

OtherPA61379CA · Physician Assistant Board

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

Annisa Nabila Soeboer Pa-c 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 ID1254709231
PECOS Enrollment IDI20231201002350
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
105 services104 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
32 services32 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
23 services23 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
21 services21 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
21 services21 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94538 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.11/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.33
Promoting Interoperability99
Improvement Activities40
Cost69.53

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.

TESFOM BERHE CCP
Perfusionist
2000 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 797-1111
MRS. SHERRIE DENISE KNEEBONE N.P.
Nurse Practitioner (Family)
2000 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 795-2004
DR. ALEXANDER P SAH MD
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
2000 MOWRY AVE, CENTER FOR JOINT REPLACEMENT BLDG
FREMONT, CA 94538
Alameda County (510) 818-7200
JESSICA YOUNG NP
Nurse Practitioner (Family)
2000 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 797-1111
PAUL VINCENT AGUILERA MD
Internal Medicine
2000 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 797-1111
DR. ANKUR AJAY DOSHI MD
Radiology (Vascular & Interventional Radiology)
2000 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 818-7362
MEDIHA SIDDIQUI JALEEL MD
Internal Medicine
2000 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 797-1111
DR. LYN MARISE DOS SANTOS MD
Pediatrics
2000 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 795-2002

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Annisa Soeboer's NPI number?

The NPI number for Annisa Soeboer is 1053985929. It was assigned to this individual provider in the NPPES registry on May 16, 2021.

Where is Annisa Soeboer located?

Annisa Soeboer practices at 2000 Mowry Ave, Fremont, CA 94538. The listed phone number is (707) 771-5687.

What is Annisa Soeboer's specialty?

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

Is Annisa Soeboer enrolled in Medicare?

Yes. Annisa Soeboer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Annisa Soeboer was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.