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

SUN CAPTAIN PA-C
NPI 1265791891
Physician Assistant - Medical in Berkeley, CA

Active since May 16, 2012PECOS Enrolled
3031 TELEGRAPH AVE STE 217, BERKELEY, CA 94705(510) 981-8222(510) 981-8228 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sun Captain Pa-c NPPES

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

SUN CAPTAIN PA-C (NPI 1265791891) is an individual medical provider in Berkeley, California, licensed in California (PA17206) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265791891
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameSUN CAPTAINCredential: PA-C
Location Address3031 TELEGRAPH AVE STE 217Berkeley, CA 94705-2053
Mailing Address601 Van Ness Ave Apt 52San Francisco, CA 94102-3263 · (415) 794-8441 · Fax (510) 981-8228
Phone(510) 981-8222
Fax(510) 981-8228
Sole ProprietorNo
Enumeration DateMay 16, 2012
Last NPPES UpdateMarch 7, 2023
✔ NPI 1265791891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · PA17206
3031 TELEGRAPH AVE STE 217, Berkeley, CA 94705
Open in Google Maps ↗

Other Identifiers 1

OtherPA 17206CA · Pa License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sun Captain Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Sun Captain's NPI number?

The NPI number for Sun Captain is 1265791891. It was assigned to this individual provider in the NPPES registry on May 16, 2012.

Where is Sun Captain located?

Sun Captain practices at 3031 Telegraph Ave Ste 217, Berkeley, CA 94705. The listed phone number is (510) 981-8222.

What is Sun Captain's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Sun Captain enrolled in Medicare?

Yes. Sun Captain is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sun Captain 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.