NPIMap

Individual provider Active NPI

Courtney A Eastman, PA-C

  • Medical Physician Assistant
  • Fresno, CA
National Provider Identifier
1073873741
Registry record updated May 9, 2018
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Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
22221 Issued in CA
Practice address
1630 E Herndon Ave
Fresno, CA 93720-3391
Phone
(559) 256-5200
Fax
(559) 256-5376
NPI assigned
May 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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 22221 CA Primary

Addresses

Primary practice location

1630 E Herndon Ave
Fresno, CA 93720-3391

Mailing address

135 Carmen LN
Santa Maria, CA 93458-7729
Phone (806) 928-7361

Other identifiers 1

IdentifierTypeStateIssuer
22221OtherCAPHYSICAN ASSISTANT COMMITTEE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120918000849 CA Practitioner - Physician Assistant 5991953879 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
Telehealth
Offers telehealth services
Group practices
David B. HammerGroup PAC ID 3971559881, 117 clinicians

Practice addresses (Care Compare)

1051 Las Tablas Rd
Templeton, CA 93465-5603

1154 E Grand Ave
Arroyo Grande, CA 93420-2583
Phone (805) 395-3277

35 Casa St
San Luis Obispo, CA 93405-1894

6955 El Camino Real
Suite 101
Atascadero, CA 93422-4216
Phone (805) 395-3277

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
64.37
Promoting interoperability
100
Improvement activities
40
Cost
72.88

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22221CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Mar 29, 2024 Accepting new patients
First Choice Physician Partners CurrentSince Dec 1, 2022 Accepting new patients
Adventist Health Physicians Network CurrentSince Mar 29, 2024 Accepting new patients
Sierra Pacific Orthopaedic Center Medical Group, Inc. CurrentSince May 9, 2018 Accepting new patients
First Choice Physician Partners Past Accepting new patients

Locations

1154 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 395-3277

1630 E Herndon Ave
Fresno, CA 93720
Phone (559) 256-5200

1220 Las Tablas Rd
#1418
Templeton, CA 93465
Phone (805) 434-1825

Interoperability endpoints

  • Direct secure messaging: courtney.eastman.1@31068.direct.athenahealth.com

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.

Hospital & facility affiliations 4

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": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1073873741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 CARMEN LN",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587729",
            "telephone_number": "806-928-7361",
            "fax_number": "805-928-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203391",
            "telephone_number": "559-256-5200",
            "fax_number": "559-256-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "COURTNEY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "22221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAN ASSISTANT COMMITTEE LICENSE",
            "identifier": "22221",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.