Individual provider Active NPI

Timothy Jesse Nersy, PA-C

  • Physician Assistant
  • Turlock, CA
National Provider Identifier
1063340941
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA68422 Issued in CA
Practice address
825 Delbon Ave
Turlock, CA 95382-2016
Phone
(209) 667-4200
NPI assigned
May 12, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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 PA68422 CA Primary

Addresses

Primary practice location

825 Delbon Ave
Turlock, CA 95382-2016

Mailing address

PO Box 743
Ceres, CA 95307-0743
Phone (209) 614-5407

Medicare participation

Medicare enrollment files
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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2100 Powell St
Emeryville, CA 94608-1826

2100 Powell St
Suite 400
Emeryville, CA 94608-1872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1778544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1063340941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953070743",
            "telephone_number": "209-614-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DELBON AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822016",
            "telephone_number": "209-667-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NERSY",
        "first_name": "TIMOTHY",
        "middle_name": "JESSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-12",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA68422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.