Active NPI
Mary Ann Sayon
- Gerontology Nurse Practitioner
- Yucca Valley, CA
National Provider Identifier
1164028080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 95016062
- Practice address
- 57402 Twentynine Palms Highway #1
Yucca, Valley, CA 92284 - Phone
- (310) 384-0371
- NPI assigned
- Dec 7, 2020
- Last updated
- Dec 7, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 95016062 | CA | Primary |
Addresses
Primary practice location
57402 Twentynine Palms Highway #1
Yucca, Valley, CA 92284
Mailing address
73373 Country Club Dr Apt 3001
Palm Desert, CA 92260-8642
Phone (310) 384-0371
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 |
|---|---|---|---|---|
| I20210401001089 | CA | Practitioner - Nurse Practitioner | 3375950694 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Perz, DO Inc. | Past | Accepting new patients |
Organizations & group practices 1
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": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607299200000",
"number": "1164028080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73373 COUNTRY CLUB DR APT 3001",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922608642",
"telephone_number": "310-384-0371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57402 TWENTYNINE PALMS HIGHWAY #1",
"city": "YUCCA, VALLEY",
"state": "CA",
"postal_code": "92284",
"telephone_number": "310-384-0371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAYON",
"first_name": "MARY ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-07",
"last_updated": "2020-12-07",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "95016062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Yucca Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.