Individual provider Active NPI

Laura A Cronin, PA

  • Physician Assistant
  • Escondido, CA
National Provider Identifier
1023445483
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58201 Issued in CA
Practice address
215 S Hickory St Ste 114
Escondido, CA 92025-4360
Phone
(760) 704-9429
NPI assigned
Oct 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2014-0011 NM
Physician Assistant 363A00000X 085004674 IL
Physician Assistant 363A00000X PA9109679 FL
Physician Assistant 363A00000X 58201 CA Primary

Addresses

Primary practice location

215 S Hickory St Ste 114
Escondido, CA 92025-4360

Mailing address

PO Box 158
El Centro Family Health, 538 N.Paseo de Onate
Espanola, NM 87532-0158
Phone (773) 227-3669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20140606001642 NM Practitioner - Physician Assistant 8123258217 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9109679FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince May 1, 2017 Accepting new patients
El Centro Family Health CurrentSince Mar 24, 2014 Accepting new patients
Presbyterian Healthcare Services CurrentSince May 1, 2017 Accepting new patients
El Centro Family Health CurrentSince Mar 24, 2014 Accepting new patients
El Centro Family Health Past Accepting new patients
Christian R Small MD a Professional Corporation Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1235 8th St
Las Vegas, NM 87701
Phone (505) 425-6751

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1023445483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "address_2": "EL CENTRO FAMILY HEALTH, 538 N.PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875320158",
            "telephone_number": "773-227-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S HICKORY ST STE 114",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254360",
            "telephone_number": "760-704-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "LAURA",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2014-0011",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004674",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109679",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.