WILLIAMRAY TATLONGHARI PA-C
NPI 1629628649
Physician Assistant in Santa Cruz, CA

Q: What is Williamray Tatlonghari's NPI number?

The NPI number for Williamray Tatlonghari is 1629628649. It was assigned to this individual provider in the NPPES registry on September 12, 2019.

Q: What is Williamray Tatlonghari's specialty?

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

Active since September 12, 2019PECOS EnrolledAccepts Medicare Assignment

84.92/100

CMS Quality Rating

2025 SOQUEL AVE, SANTA CRUZ, CA 95062(831) 458-5524 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2021, Sep 12, 2019 (2 updates tracked since 2019).

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About Williamray Tatlonghari Pa-c NPPES

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

WILLIAMRAY TATLONGHARI PA-C (NPI 1629628649) is an individual physician assistant in Santa Cruz, California, licensed in California (59236) and active in the NPI registry since September 2019. He is enrolled in Medicare PECOS and is a graduate of University Of Washington School Of Medicine (2020).

NPPES Registry Identity

NPI1629628649

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameWILLIAMRAY TATLONGHARICredential: PA-C

Location Address2025 SOQUEL AVESanta Cruz, CA 95062-1323

Mailing Address325 Distel CirLos Altos, CA 94022-1408

Phone(831) 458-5524

Sole ProprietorNo

Medical School CMSUniversity Of Washington School Of MedicineGraduated 2020

Enumeration DateSeptember 12, 2019

Last NPPES UpdateSeptember 13, 20232 updates tracked since enumeration

NPPES CertifiedSeptember 13, 2023

✔ NPI 1629628649 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 · 59236

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.

2025 SOQUEL AVE, Santa Cruz, CA 95062

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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

Williamray Tatlonghari 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 ID9133514680

PECOS Enrollment IDI20220318001222

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

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 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.

25 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95062 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

$96.03 typical visit price

range $62.97 – $186.69

Typical copayment $24.00 (range $15.74 – $46.67)

Most-billed visit code 99203

Established Patient

$77.84 typical visit price

range $21.02 – $153.16

Typical copayment $19.46 (range $5.25 – $38.29)

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.

84.92/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

66.98

Promoting Interoperability

100

Improvement Activities

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.

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