Individual provider Active NPI

Ronald Traylor, PA-C

  • Physician Assistant
  • Merced, CA
National Provider Identifier
1114079050
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14547 Issued in CA
Practice address
3349 G St Ste F
Merced, CA 95340-0978
Phone
(209) 723-3704
Fax
(209) 723-0272
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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 PA14547 CA Primary

Addresses

Primary practice location

3349 G St Ste F
Merced, CA 95340-0978

Mailing address

3349 G St Ste F
Merced, CA 95340-0978
Phone (209) 349-8459

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
I20071203000299 CA Practitioner - Physician Assistant 0840389698 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy S. Johnston, M.D. PC CurrentSince Apr 1, 2017 Accepting new patients
Timothy S. Johnston, M.D. PC Past Accepting new patients
Mark S Spitzer D O Past Accepting new patients

Locations

3349 G St
Ste F
Merced, CA 95340
Phone (209) 349-8459

3170 Collins Dr
Ste B
Merced, CA 95348
Phone (209) 233-3840

410 E Yosemite Ave
Ste B
Merced, CA 95340
Phone (209) 722-9272

Interoperability endpoints

  • Direct secure messaging: ronald.traylor.p1@direct.spocortho.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1114079050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 G ST STE F",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-349-8459",
            "fax_number": "209-349-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 G ST STE F",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-723-3704",
            "fax_number": "209-723-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYLOR",
        "first_name": "RONALD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.