Active NPI
Juan Contreras, PA-C
- Physician Assistant
- Tulare, CA
National Provider Identifier
1124064829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA14734
- Practice address
- 922 N Cherry St
Suite B
Tulare, CA 93274-2210 - Phone
- (559) 684-7800
- Fax
- (559) 684-7804
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
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 | PA14734 | CA | Primary |
Addresses
Primary practice location
922 N Cherry St
Suite B
Tulare, CA 93274-2210
Mailing address
922 W Cherry St.
Suite B
Tulare, CA 93274
Phone (559) 684-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA14734 | Medicaid | CA |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051014000781 | CA | Practitioner - Physician Assistant | 8628094059 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Wellness Center and Walk-in Clinic Inc
Practice addresses (Care Compare)
1159 N Cherry St
Tulare, CA 93274-2231
Phone (559) 684-7700
Hospital & facility affiliations
- Adventist Health Home Care Services
- Adventist Health Tulare
- Kaweah Health Medical Center
- Adventist Health Hanford
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14734 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tulare Walk-in Clinic & Wellness Center Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinic/Center
- Tulare, CA
- NPI 1831271576
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Hanford, CA
- NPI 1033397336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124064829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "922 W CHERRY ST.",
"address_2": "SUITE B",
"city": "TULARE",
"state": "CA",
"postal_code": "93274",
"telephone_number": "559-684-7800",
"fax_number": "559-684-7804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "922 N CHERRY ST",
"address_2": "SUITE B",
"city": "TULARE",
"state": "CA",
"postal_code": "932742210",
"telephone_number": "559-684-7800",
"fax_number": "559-684-7804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONTRERAS",
"first_name": "JUAN",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA14734",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA14734",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulare, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.