Individual provider Active NPI

Wyatt Stebbins, PA-C

  • Physician Assistant
  • Sonora, CA
National Provider Identifier
1003264359
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1000 Greenley Rd
Sonora, CA 95370-5200
Phone
(209) 532-1326
NPI assigned
May 27, 2016
Last updated
May 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1000 Greenley Rd
Sonora, CA 95370-5200

Mailing address

PO Box 4685
Sonora, CA 95370-1685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250814000291 MN Practitioner - Physician Assistant 5597051870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1700 University Ave W
St Paul, MN 55104-3727

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as group
Quality
90.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
81.74
Promoting interoperability
97
Improvement activities
40
Cost
67.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2188NEMDHospitalist Physician
53612CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Jul 21, 2025 Accepting new patients
Sonora Community Hospital CurrentSince Aug 15, 2021 Accepting new patients
Fairview Health Services CurrentSince Jul 21, 2025 Accepting new patients
Sonora Community Hospital CurrentSince Aug 15, 2021 Accepting new patients

Locations

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

14540 State Highway 108
Sonora, CA 95370
Phone (209) 532-3167

680 Guzzi Ln
Ste 201
Sonora, CA 95370
Phone (209) 536-1785

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1003264359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4685",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953701685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREENLEY RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705200",
            "telephone_number": "209-532-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEBBINS",
        "first_name": "WYATT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.