Individual provider Active NPI

James M Mabry, PA-C

  • Surgical Physician Assistant
  • Grass Valley, CA
National Provider Identifier
1093064107
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA22458 Issued in CA
Practice address
360 Sierra College Dr Ste 120
Grass Valley, CA 95945-5088
Phone
(530) 274-6222
Fax
(530) 242-4846
NPI assigned
Sep 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA22458 CA Primary

Addresses

Primary practice location

360 Sierra College Dr Ste 120
Grass Valley, CA 95945-5088

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121026000348 CA Practitioner - Physician Assistant 4981854098 Reassigns benefits to 1 organization
I20200821001296 MT Practitioner - Physician Assistant 4981854098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

155 Glasson Way
Suite L 10
Grass Valley, CA 95945-5723
Phone (530) 274-6677

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

280 Sierra College Dr
Grass Valley, CA 95945-5763

360 Sierra College Dr
Suite 120
Grass Valley, CA 95945-5088
Phone (530) 477-8358

Hospital & facility affiliations

  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA22458CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marcus Daly Memorial Hospital Corporation CurrentSince Jun 23, 2020 Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Jun 23, 2020 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince May 23, 2021 Accepting new patients
Sierra Nevada Memorial-Miners Hospital Past Accepting new patients
Cogent Healthcare of California, PC Physician Assistant Past Accepting new patients
Cogent Healthcare of California, PC Physician Assistant Past Accepting new patients

Locations

360 Sierra College Dr
Ste 120
Grass Valley, CA 95945
Phone (530) 477-7390

155 Glasson Way
Grass Valley, CA 95945
Phone (530) 274-6000

280 Sierra College Dr
Ste 105
Grass Valley, CA 95945
Phone (530) 273-3400

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

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 1

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": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1093064107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SIERRA COLLEGE DR STE 120",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455088",
            "telephone_number": "530-274-6222",
            "fax_number": "530-242-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-05",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA22458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.