Active NPI
Richard Robert Decker, P.A-C
- Physician Assistant
- Apple Valley, CA
National Provider Identifier
1083658975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA16620
- Practice address
- 18300 Highway 18
Apple Valley, CA 92307 - Phone
- (760) 242-2311
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA16620 | CA | Primary |
Addresses
Primary practice location
18300 Highway 18
Apple Valley, CA 92307
Mailing address
2100 Powell Street
Ste 920
Emeryville, CA 94608-1803
Phone (510) 350-2777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1662 | CA | MD | Professional Counselor |
| PA16620 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Emergency Physicians of California Medical Group PC | Physician Assistant | Past | Accepting new patients |
| Rainbow Basin Emergency Physicians, a Medical Corporation | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Barstow, CA
- NPI 1225289135
Physician Assistant
-
- Emergency Medicine Physician
- Barstow, CA
- NPI 1811148729
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083658975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL STREET",
"address_2": "STE 920",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081803",
"telephone_number": "510-350-2777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 HIGHWAY 18",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "92307",
"telephone_number": "760-242-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "RICHARD",
"middle_name": "ROBERT",
"credential": "P.A-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA16620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.