Robert Jazwin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16120 Issued in CA

Practice address

5300 Highway 49 N
Mariposa, CA 95338-0155

Phone

(209) 966-3672

Fax

(209) 966-5548

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Provident Primary Care Inc

  • Primary Care Clinic/Center
  • Merced, CA
  • NPI 1154785517
  Medicare reassignment
• Rama L R Nandipati M D Inc

  • Pulmonary Disease Physician
  • Merced, CA
  • NPI 1003932930
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437177600000",
    "number": "1164581211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3768",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953443768",
            "telephone_number": "209-725-7149",
            "fax_number": "209-726-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 HIGHWAY 49 N",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953380155",
            "telephone_number": "209-966-3672",
            "fax_number": "209-966-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAZWIN",
        "first_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2015-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 16120",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Thomas Horvat, MD, PHD
• Brandi Bae Howes-Medley, ACSW
• Debra A Hutchins, LCSW
• James Anthony Jardin
• Wendy C Jaskowiak
• Kyle Jenkins, MFTI
• John C Fremont Healthcare District
• John C Fremont Healthcare District
• John C Fremont Healthcare District
• John C Fremont Healthcare District

• Physician Assistant in Mariposa, CA
• Providers in Mariposa, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; 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.

Verify at the official NPI Registry.