Individual provider Active NPI

Gregory Joel McGuinn, PA-C

  • Medical Physician Assistant
  • Yucca Valley, CA
National Provider Identifier
1174637581
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA21603 Issued in CA
Practice address
57675 29 Palms Hwy
Ste 111
Yucca Valley, CA 92284-3098
Phone
(760) 365-8500
Fax
(760) 365-8599
NPI assigned
Aug 19, 2006
Last updated
Jan 9, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA21603 CA Primary

Addresses

Primary practice location

57675 29 Palms Hwy
Ste 111
Yucca Valley, CA 92284-3098

Mailing address

6826 Hathaway Dr
Las Vegas, NV 89156-7143
Phone (702) 370-3930

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
I20150902003171 CA Order and Referring Only - Physician Assistant 3072700871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA21603CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yucca Family Medical Care, Inc. Past Accepting new patients
Physician to You LLC Past Accepting new patients
Yucca Family Medical Care, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCGCDA

Organizations & group practices 3

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1174637581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6826 HATHAWAY DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891567143",
            "telephone_number": "702-370-3930",
            "fax_number": "702-459-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57675 29 PALMS HWY",
            "address_2": "STE 111",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922843098",
            "telephone_number": "760-365-8500",
            "fax_number": "760-365-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUINN",
        "first_name": "GREGORY",
        "middle_name": "JOEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

Verify at the official NPI Registry.