Individual provider Active NPI

John Andrew Dorosin, PA-C

  • Physician Assistant
  • Santa Cruz, CA
National Provider Identifier
1114107018
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19456 Issued in CA
Practice address
1662 Dominican Way
Santa Cruz, CA 95065-1522
Phone
(831) 475-1100
NPI assigned
Nov 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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 PA19456 CA Primary

Addresses

Primary practice location

1662 Dominican Way
Santa Cruz, CA 95065-1522

Mailing address

PO Box 1833
Santa Cruz, CA 95061-1833

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
I20080109000785 CA Practitioner - Physician Assistant 6305926890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2900 Chanticleer Ave
Santa Cruz, CA 95065-1816

2907 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2375

2911 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2350

2915 Chanticleer Ave
Santa Cruz, CA 95065-1815
Phone (831) 477-2375

550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone (831) 458-5865

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

  • Sutter Maternity & Surgery Center of Santa Cruz Hospital, Santa Cruz, CA, CCN 050714
  • Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19456CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Medical Clinic, Inc Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
Dignity Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jdorosinpa26054@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1114107018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1833",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950611833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 DOMINICAN WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651522",
            "telephone_number": "831-475-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOROSIN",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.