Kevin Noel Bixel, PA – Physician Assistant

Key facts

NPI: 1063403376
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: PA16505 (CA)
Practice address: 1401 Spanos CT
Suite 130
Modesto, CA 95355-2810
Phone: (209) 550-4779
NPI assigned: Nov 4, 2005
Sex: Male
Sole proprietor: No

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.

Sutter Gould Medical Foundation Family Medicine Physician · Turlock, CA · NPI 1023065133

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
16505	CA	MD	Acupuncturist
PA16505	CA	MD	Physician Assistant

Practice roles

Organization	Specialty	Status	New patients
Sutter Gould Medical Foundation		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	PA16505	CA	Yes

Addresses

Primary practice location

1401 Spanos CT
Suite 130
Modesto, CA 95355-2810

Mailing address

1441 Florida Ave
Modesto, CA 95350-4404
Phone (209) 576-3601

Other identifiers

Identifier	Type	State	Issuer
OPA165050	Medicaid	CA
OPA165050	Other	CA	BLUE SHIELD

Other providers in Modesto, CA

All providers in Modesto, CA · Physician Assistant in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.