Ian Joseph Donahue, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

51838 Issued in CA

Practice address

1310 San Bernardino Rd
Ste. 103
Upland, CA 91786-4979

Phone

(909) 920-0444

Fax

(909) 920-5044

NPI assigned

Jan 3, 2015

Last updated

Jan 3, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Basim Z. Abdelkarim, M.D., Inc.

  dba Ideal Gastroenterology Associates

  • Gastroenterology Physician
  • Upland, CA
  • NPI 1063593739
  NPD (past)

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

{
    "created_epoch": "1420243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420243200000",
    "number": "1023406725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SAN BERNARDINO RD",
            "address_2": "STE. 103",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864979",
            "telephone_number": "909-920-0444",
            "fax_number": "909-920-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SAN BERNARDINO RD",
            "address_2": "STE. 103",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864979",
            "telephone_number": "909-920-0444",
            "fax_number": "909-920-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAHUE",
        "first_name": "IAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-03",
        "last_updated": "2015-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lolita M. Domingue, LMFT
• Dominguez Pharmacy LP (Medical Arts Pharmacy)
• Maritza Dominguez
• Olaf Dominguez, PHARMD
• Lorraine Mae Dominick, WHNP
• Donald H Spaulding OD Inc (Donald H Spaulding OD)
• Michelle Anne Donaldson, MS
• Russell Dorado, M.D.
• Timothy Dorsey
• Double Ace Home Health Services, Inc.

• Physician Assistant in Upland, CA
• Providers in Upland, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.