Jason Don Ullyott, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19754 Issued in CA

Practice address

275 Hospital Dr
Ukiah, CA 95482-4531

Phone

(707) 462-7900

Fax

(707) 462-7947

NPI assigned

Jul 14, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.76

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Redwood Medical Group Inc

  • Emergency Medicine Physician
  • Ukiah, CA
  • NPI 1033103676
  Medicare reassignment
• Pacific Redwood Medical Services

  • Internal Medicine Physician
  • Ukiah, CA
  • NPI 1295924470

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1083878532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 HOSPITAL DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824531",
            "telephone_number": "707-462-7900",
            "fax_number": "707-462-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOSPITAL DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824531",
            "telephone_number": "707-462-7900",
            "fax_number": "707-462-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLYOTT",
        "first_name": "JASON",
        "middle_name": "DON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ukiah Senior Center Inc.
• Ukiah Surgery Center LP
• Ukiah Valley Anesthesia Services
• Ukiah Valley Primary Care Medical Group, Inc
• Ukiah Valley Primary Care Medical Group, Inc
• Melanie Ann Ulvila, LCSW
• Heylee Unangst
• Sabra Underwood
• United Holistic Health, a Professional Acupuncture Corporation (Victor Cheng Traditional Chinese Medicine)
• United Medical Resources, Inc.

• Physician Assistant in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.