Individual provider Active NPI

Michael Pedrano Trias, PA-C

  • Physician Assistant
  • Whittier, CA
National Provider Identifier
1053660464
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22429 Issued in CA
Practice address
15733 Whittier Blvd
Whittier, CA 90603-2312
Phone
(562) 947-7754
NPI assigned
Aug 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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 PA22429 CA Primary

Addresses

Primary practice location

15733 Whittier Blvd
Whittier, CA 90603-2312

Mailing address

15733 Whittier Blvd
Whittier, CA 90603-2312
Phone (562) 947-7754

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
I20130625000639 CA Practitioner - Physician Assistant 5799924643 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

5101 Lakewood Blvd
Lakewood, CA 90712-2413
Phone (562) 800-3883

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 19, 2016 Accepting new patients
Pih Health Physicians CurrentSince Jan 23, 2013 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 19, 2016 Accepting new patients
Pih Health Physicians CurrentSince Jan 23, 2013 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

15733 Whittier Blvd
Whittier, CA 90603
Phone (562) 947-7754

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1053660464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15733 WHITTIER BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906032312",
            "telephone_number": "562-947-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15733 WHITTIER BLVD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906032312",
            "telephone_number": "562-947-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIAS",
        "first_name": "MICHAEL",
        "middle_name": "PEDRANO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-30",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.