Individual provider Active NPI

Mario Esquivel, P.A

  • Medical Physician Assistant
  • Corona, CA
National Provider Identifier
1215366570
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA51223 Issued in CA
Practice address
1530 W 6TH St
Suite 109
Corona, CA 92882-2742
Phone
(951) 279-2171
Fax
(951) 279-4514
NPI assigned
Nov 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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 PA51223 CA Primary

Addresses

Primary practice location

1530 W 6TH St
Suite 109
Corona, CA 92882-2742

Mailing address

1530 W 6TH St
Suite 109
Corona, CA 92882-2742
Phone (951) 279-2171

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
I20180129002611 CA Practitioner - Physician Assistant 4981964657 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA51223CAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mesquivel523406@direct.cshs.org
  • Direct secure messaging: mesquivel142427@direct.llu.edu

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1215366570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 W 6TH ST",
            "address_2": "SUITE 109",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822742",
            "telephone_number": "951-279-2171",
            "fax_number": "951-279-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 W 6TH ST",
            "address_2": "SUITE 109",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928822742",
            "telephone_number": "951-279-2171",
            "fax_number": "951-279-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIVEL",
        "first_name": "MARIO",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA51223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.