Individual provider Active NPI

Mendeleev D Locquiao, PA-C

  • Physician Assistant
  • Bakersfield, CA
National Provider Identifier
1184997751
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
420 34TH St
Bakersfield, CA 93301-2237
Phone
(661) 327-4647
NPI assigned
Feb 13, 2012
Last updated
Mar 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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 NU Primary

Addresses

Primary practice location

420 34TH St
Bakersfield, CA 93301-2237

Mailing address

PO Box 661972
Arcadia, CA 91066-1972
Phone (626) 447-0296

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
I20120417000723 CA Practitioner - Physician Assistant 7810158912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.07
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22138CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp CurrentSince Mar 1, 2012 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

Organizations & group practices 2

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": "1329091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1184997751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661972",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910661972",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 34TH ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012237",
            "telephone_number": "661-327-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCQUIAO",
        "first_name": "MENDELEEV",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.