Eric Fergen, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7075 Issued in AZ

Practice address

1355 Ramar Rd Ste 11
Bullhead City, AZ 86442-7100

Phone

(928) 704-9202

Fax

(928) 704-9207

NPI assigned

Feb 23, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, AZ, CA3 enrollments

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 3

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-State Medical Specialists LLCGroup PAC ID 1850422023, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DCHDDD/Endpoint/DCHDDD
• Direct secure messaging: eric.fergen.p1@direct.cdsdp.nextgenshare.com
• FHIR API: https://fhir4.healow.com/fhir/r4/EHDCDD/Endpoint/EHDCDD
• Direct secure messaging: efergen1653736@oc.providencedirect.org

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.

• Tri-State Medical Specialists LLC

  dba TriState Pain Institute

  • Pain Medicine Physician
  • Fort Mohave, AZ
  • NPI 1649598426
  Medicare reassignment Care Compare group NPD
• Providence Facey Medical Foundation

  dba Facey Medical Group

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment NPD
• Colorado River Primary Care, Inc

  dba Tri State Primary Care

  • Internal Medicine Physician
  • Fort Mohave, AZ
  • NPI 1669146536
  Medicare reassignment
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment
• Providence Facey Medical Foundation

  dba Providence Express Care

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD
• East Valley Urgent Care,LLC

  dba Urgent Care Extra-Bell

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1235481128
  NPD (past)

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1245622646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD STE 11",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-704-9202",
            "fax_number": "928-704-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD STE 11",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-704-9202",
            "fax_number": "928-704-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGEN",
        "first_name": "ERIC",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "57093",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Hearing, Inc.
• Meyata Farley, PMHNP
• Faylona Gollard Kaushal Nyamuswa & Park LTD (Cancer & Blood Specialists of Nevada)
• Justin R Fenus, JUSTIN FENUS
• Jim F Feren, MA
• Horst Filtzer, M.D.
• Kayla Rose Fisher, COTA
• Meredith Fisher
• Ashley Renee Flint
• George D Flitcraft, DMD

• Physician Assistant in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.