Individual provider Active NPI

Jay H Miser, PA-C

  • Medical Physician Assistant
  • Pollock Pines, CA
National Provider Identifier
1053439372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14953 Issued in CA
Practice address
6156 Pony Express TRL
Pollock Pines, CA 95726-9649
Phone
(530) 644-6044
Fax
(530) 644-0125
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA14953 CA Primary

Addresses

Primary practice location

6156 Pony Express TRL
Pollock Pines, CA 95726-9649

Mailing address

6156 Pony Express TRL
Pollock Pines, CA 95726-9649
Phone (530) 644-6044

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
I20151021002623 CA Practitioner - Physician Assistant 4183935489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

1095 Marshall Way
Placerville, CA 95667-5722

3581 Palmer Dr
Suite 602
Cameron Park, CA 95682-8238
Phone (530) 672-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA14953CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center CurrentSince Sep 1, 2021 Accepting new patients
Marshall Medical Center CurrentSince Sep 1, 2021 Accepting new patients
Marshall Medical Center Past Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

1095 Marshall Way
#100
Placerville, CA 95667
Phone (530) 626-2920

1095 Marshall Way
Ste 100
Placerville, CA 95667
Phone (530) 344-5470

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

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 1

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053439372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6156 PONY EXPRESS TRL",
            "city": "POLLOCK PINES",
            "state": "CA",
            "postal_code": "957269649",
            "telephone_number": "530-644-6044",
            "fax_number": "530-644-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6156 PONY EXPRESS TRL",
            "city": "POLLOCK PINES",
            "state": "CA",
            "postal_code": "957269649",
            "telephone_number": "530-644-6044",
            "fax_number": "530-644-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISER",
        "first_name": "JAY",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pollock Pines, CA

Sources for this page

Verify at the official NPI Registry.