Individual provider Active NPI

Brian Taylor, PA

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1043846017
Registry record updated Oct 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7766 N Palm Ave Ste 107
Fresno, CA 93711-5734
Phone
(559) 435-0800
Fax
(559) 435-7720
NPI assigned
Mar 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2020

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 CA Primary

Addresses

Primary practice location

7766 N Palm Ave Ste 107
Fresno, CA 93711-5734

Mailing address

7766 N Palm Ave Ste 107
Fresno, CA 93711-5734
Phone (559) 435-0800

Other practice location 1

88 S Garfield Ave Unit 451
Alhambra, CA 91801-6846
Phone (559) 801-7473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220215001191 CA Practitioner - Physician Assistant 0840683876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dwight W Sievert MD IncGroup PAC ID 1052365103, 2 clinicians

Practice addresses (Care Compare)

7766 N Palm Ave
Suite 107
Fresno, CA 93711-5708
Phone (559) 435-0800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58203CAMDDentist

Organizations & group practices 1

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602374400000",
    "number": "1043846017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7766 N PALM AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115734",
            "telephone_number": "559-435-0800",
            "fax_number": "559-435-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7766 N PALM AVE STE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115734",
            "telephone_number": "559-435-0800",
            "fax_number": "559-435-7720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "88 S Garfield Ave Unit 451",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918016846",
            "country_code": "US",
            "telephone_number": "559-801-7473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRIAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-20",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.