Individual provider Active NPI

Destinee Bowden

  • Physician Assistant
  • Madera, CA
National Provider Identifier
1093319915
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
58935 Issued in CA
Practice address
344 E 6TH St
Madera, CA 93638-3631
Phone
(559) 664-4000
Fax
(559) 675-5224
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 58935 CA Primary

Addresses

Primary practice location

344 E 6TH St
Madera, CA 93638-3631

Mailing address

344 E 6TH St
Madera, CA 93638-3631
Phone (559) 664-4000

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
I20211102001046 CA Practitioner - Physician Assistant 7618365131 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58935CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health CurrentSince Jul 13, 2021 Accepting new patients
Camarena Health CurrentSince Jul 13, 2021 Accepting new patients

Locations

344 E 6th St
Madera, CA 93638
Phone (559) 664-4158

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1093319915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 6TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383631",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 6TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383631",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "DESTINEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.