Active NPI
Jester Mark Callejo Odrunia
- Physician Assistant
- Sonora, CA
National Provider Identifier
1114722592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA66131
- Practice address
- 900 Mono Way
Sonora, CA 95370-5229 - Phone
- (694) 020-9536
- NPI assigned
- Feb 18, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA66131 | CA | Primary |
Addresses
Primary practice location
900 Mono Way
Sonora, CA 95370-5229
Mailing address
10301 Lake Bracciano Ave
Bakersfield, CA 93311-8216
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
680 Guzzi LN
Sonora, CA 95370-5288
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA66131 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonora Community Hospital | Multi-Specialty | Current | Accepting new patients |
| Sonora Community Hospital | Past | Accepting new patients |
Locations
1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803
900 Mono Way
Sonora, CA 95370
Phone (209) 536-6925
680 Guzzi Ln
Ste 106
Sonora, CA 95370
Phone (209) 532-2792
680 Guzzi Ln
Ste 201
Sonora, CA 95370
Phone (209) 536-1785
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.
-
- Radiation Oncology Clinic/Center
- Sonora, CA
- NPI 1891732418
-
- Family Medicine Physician
- Groveland, CA
- NPI 1356332274
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sonora, CA
- NPI 1780673376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743033600000",
"number": "1114722592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10301 LAKE BRACCIANO AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933118216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MONO WAY",
"city": "SONORA",
"state": "CA",
"postal_code": "953705229",
"telephone_number": "694-020-9536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODRUNIA",
"first_name": "JESTER",
"middle_name": "MARK CALLEJO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-02-18",
"last_updated": "2025-03-27",
"certification_date": "2025-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA66131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.