PATRICIA ANNE TANAEL MEDALLA M.S. CCC-SLP
NPI 1255969176
Speech-Language Pathologist in Fremont, CA

Q: What is Patricia Anne Medalla's NPI number?

The NPI number for Patricia Anne Medalla is 1255969176. It was assigned to this individual provider in the NPPES registry on March 27, 2020.

Q: What is Patricia Anne Medalla's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Active since March 27, 2020

38627 CHERRY LN APT 81, FREMONT, CA 94536(510) 402-7368 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Feb 11, 2022, Mar 27, 2020 (2 updates tracked since 2020).

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About Patricia Anne Tanael Medalla M.s. Ccc-slp NPPES

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

PATRICIA ANNE TANAEL MEDALLA M.S. CCC-SLP (NPI 1255969176) is an individual speech-language pathologist provider in Fremont, California, licensed in California (28937) and active in the NPI registry since March 2020.

NPPES Registry Identity

NPI1255969176

Entity TypeIndividualFemale

Primary Taxonomy235Z00000X

Provider Legal NamePATRICIA ANNE TANAEL MEDALLACredential: M.S. CCC-SLP

Location Address38627 CHERRY LN APT 81Fremont, CA 94536-4270

Mailing Address30927 Union City BlvdUnion City, CA 94587-2547 · (510) 402-7368

Phone(510) 402-7368

Sole ProprietorYes

Enumeration DateMarch 27, 2020

Last NPPES UpdateFebruary 11, 20222 updates tracked since enumeration

NPPES CertifiedAugust 31, 2021

✔ NPI 1255969176 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers

Taxonomy Code235Z00000X

License✔ Licensed in CA · 28937

Definition

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

38627 CHERRY LN APT 81, Fremont, CA 94536

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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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Patricia Anne Tanael Medalla M.s. Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Patricia Anne Medalla reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

15 mi

Internal Medicine

1190 VETERANS BLVD
Redwood City, CA 94063

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1639252604 (650) 299-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Patricia Anne Medalla's NPI number?

The NPI number for Patricia Anne Medalla is 1255969176. It was assigned to this individual provider in the NPPES registry on March 27, 2020.

Where is Patricia Anne Medalla located?

Patricia Anne Medalla practices at 38627 Cherry Ln Apt 81, Fremont, CA 94536. The listed phone number is (510) 402-7368.

What is Patricia Anne Medalla's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Patricia Anne Medalla enrolled in Medicare?

Yes. Patricia Anne Medalla is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Patricia Anne Medalla's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Patricia Anne Medalla reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Patricia Anne Medalla's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Patricia Anne Medalla was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.