Individual provider Active NPI

Heliodoro Magana

  • Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1093192650
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA52395 Issued in CA
Practice address
9805 Stockdale Hwy Ste 105
Bakersfield, CA 93311
Phone
(661) 665-7880
Fax
(661) 665-7880
NPI assigned
May 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA52395 CA Primary

Addresses

Primary practice location

9805 Stockdale Hwy Ste 105
Bakersfield, CA 93311

Mailing address

9802 Stockdale Hwy Ste 105
Bakersfield, CA 93311-3653
Phone (661) 665-7880

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151112002044 CA Practitioner - Physician Assistant 6800106360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

200 W Ctr St Promenade
Anaheim, CA 92805-3960

500 Doyle Park Dr
Santa Rosa, CA 95405-4559

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA52395CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Sep 19, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Sep 19, 2022 Accepting new patients
Regenerative Spine, Pain, and Neuropathy Centers, Inc. PastSince Jun 22, 2021 Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients

Locations

2675 Harris St
Eureka, CA 95503
Phone (707) 269-0644

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 300
Santa Rosa, CA 95405
Phone (707) 303-8320

Organizations & group practices 6

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": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1093192650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9802 STOCKDALE HWY STE 105",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933113653",
            "telephone_number": "661-665-7880",
            "fax_number": "661-665-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9805 STOCKDALE HWY STE 105",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93311",
            "telephone_number": "661-665-7880",
            "fax_number": "661-665-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGANA",
        "first_name": "HELIODORO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2021-05-11",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA52395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.