Individual provider Active NPI

Nicholas Ray Spear, PA-C

  • Physician Assistant
  • Ramona, CA
National Provider Identifier
1144985128
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60313 Issued in CA
Practice address
16603 John Henry LN
Ramona, CA 92065-6931
Phone
(619) 699-9839
NPI assigned
Nov 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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 60313 CA Primary

Addresses

Primary practice location

16603 John Henry LN
Ramona, CA 92065-6931

Mailing address

PO Box 176
Palomar Mountain, CA 92060-0176
Phone (619) 699-9839

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
I20211223001594 CA Practitioner - Physician Assistant 4082005202 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Loma Linda University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arch Health Partners IncGroup PAC ID 9931239027, 141 clinicians

Practice addresses (Care Compare)

15611 Pomerado Rd
Poway, CA 92064-2437
Phone (858) 675-3100

211 13TH St
Ramona, CA 92065-2711
Phone (760) 789-5160

Hospital & facility affiliations

  • Palomar Medical Center Poway Hospital, Poway, CA, CCN 050636

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arch Health Partners, Inc CurrentSince Jan 3, 2022 Accepting new patients
Arch Health Partners CurrentSince Jan 3, 2022 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Two Zeds Medical Corporation Past Accepting new patients

Locations

225 E 2nd Ave
Escondido, CA 92025

15611 Pomerado Rd
Ste 400
Poway, CA 92064
Phone (858) 613-8900

Interoperability endpoints

  • Direct secure messaging: nicholas.spear.p1@direct.arch.nextgenshare.com
  • Direct secure messaging: nspear2255782@oc.providencedirect.org

Organizations & group practices 6

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 1

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1144985128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 176",
            "city": "PALOMAR MOUNTAIN",
            "state": "CA",
            "postal_code": "920600176",
            "telephone_number": "619-699-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16603 JOHN HENRY LN",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920656931",
            "telephone_number": "619-699-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAR",
        "first_name": "NICHOLAS",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ramona, CA

Sources for this page

Verify at the official NPI Registry.