Michael Gavin Deguzman, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 14892 Issued in CA

Practice address

12712 Heacock St Ste 3
Moreno Valley, CA 92553-3037

Phone

(951) 601-6802

Fax

(951) 601-9263

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Group practices

Comprehensive Primary Care Medical Associates, IncGroup PAC ID 5092780833, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Compre Hensive Primary Care Medical Associates, Inc

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1982786620
  Medicare reassignment Care Compare group
• Reuben C Castillo, Professional Corporation

  • General Practice Physician
  • Perris, CA
  • NPI 1942429188
  NPD (past)
• Riverside Regional Pediatric Medical Group, Inc.

  • Specialist
  • Moreno Valley, CA
  • NPI 1437230687
  NPD (past)
• Senior'S Choice Medical Group, Inc.

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1023506672
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235202144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4434",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917294434",
            "telephone_number": "909-466-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12712 HEACOCK ST STE 3",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533037",
            "telephone_number": "951-601-6802",
            "fax_number": "951-601-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUZMAN",
        "first_name": "MICHAEL",
        "middle_name": "GAVIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 14892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esteban Juan De Los Reyes, BA
• Olga Judith Deaton
• Debra Warner
• Sharn Deep, PMHNP-BC
• Anne Deffebach, DO
• Adrienne Dehaas, MFT
• Kayvon Seyed Dehghanian, MD
• Elyse Diana Dejohnette, LMFT
• Diego Jesus Del Carpio, MD
• Lorena Del Rio

• Medical Physician Assistant in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.