Individual provider Active NPI

Joshua Lucas Ninichuck, PA-C, MPAP

  • Physician Assistant
  • Danville, CA
National Provider Identifier
1164651121
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
20358 Issued in CA
Practice address
1320 El Capitan Dr Ste 200
Danville, CA 94526-6260
Phone
(925) 275-0700
Fax
(925) 275-0701
NPI assigned
Jul 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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 20358 CA Primary

Addresses

Primary practice location

1320 El Capitan Dr Ste 200
Danville, CA 94526-6260

Mailing address

1320 El Capitan Dr Ste 200
Danville, CA 94526-6260
Phone (925) 275-0700

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
I20161020002433 CA Practitioner - Physician Assistant 6507005105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert a. Rovner, MD, a Professional CorporationGroup PAC ID 6406072685, 2 clinicians

Practice addresses (Care Compare)

1320 El Capitan Dr
Suite 200
Danville, CA 94526-6258

1320 El Capitan Dr
Suite 200
Danville, CA 94526-6260
Phone (925) 275-0700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
86.58
Improvement activities
40
Cost
87.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20358CAMDProfessional Counselor
1923SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
San Ramon Regional Medical Center, LLC Past Accepting new patients
Pee Dee Orthopedic Assoc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jninichuck138558@hpmg.direct-ci.net

Organizations & group practices 4

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": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1164651121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 EL CAPITAN DR STE 200",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945266260",
            "telephone_number": "925-275-0700",
            "fax_number": "925-275-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 EL CAPITAN DR STE 200",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945266260",
            "telephone_number": "925-275-0700",
            "fax_number": "925-275-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NINICHUCK",
        "first_name": "JOSHUA",
        "middle_name": "LUCAS",
        "name_prefix": "Mr.",
        "credential": "PA-C, MPAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

Verify at the official NPI Registry.