NPIMap

Individual provider Active NPI

Gunnar Erik Rohde-Moe, PA-C

  • Medical Physician Assistant
  • Sonora, CA
National Provider Identifier
1215912019
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 15041 Issued in CA
Practice address
14677 Deon Dr
Sonora, CA 95370-9662
Phone
(209) 532-1844
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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 PA 15041 CA Primary

Addresses

Primary practice location

14677 Deon Dr
Sonora, CA 95370-9662

Mailing address

14677 Deon Dr
Sonora, CA 95370-9662
Phone (209) 532-1844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081020000580 CA Practitioner - Physician Assistant 7911065917 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonora Community HospitalGroup PAC ID 4284538505, shared by 10 NPIs, 134 clinicians

Practice addresses (Care Compare)

193 Fairview LN
Sonora, CA 95370-4828
Phone (209) 536-5100

Hospital & facility affiliations

  • Adventist Health Sonora Hospital, Sonora, CA, CCN 050335

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
81.74
Promoting interoperability
97
Improvement activities
40
Cost
67.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 15041CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sonora Community Hospital CurrentSince Aug 7, 2023 Accepting new patients
Cep America - California Past Accepting new patients
Sonora Community Hospital Past Accepting new patients

Locations

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

193 Fairview Ln
Ste C
Sonora, CA 95370
Phone (209) 532-3124

193 Fairview Ln
Sonora, CA 95370
Phone (209) 536-5100

193 Fairview Ln
Ste B
Sonora, CA 95370
Phone (209) 532-5100

Organizations & group practices 6

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 12

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1215912019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14677 DEON DR",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709662",
            "telephone_number": "209-532-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14677 DEON DR",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709662",
            "telephone_number": "209-532-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHDE-MOE",
        "first_name": "GUNNAR",
        "middle_name": "ERIK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 15041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.