Individual provider Active NPI

Les Allen Mershon, PA-C

  • Medical Physician Assistant
  • La Mesa, CA
National Provider Identifier
1265723985
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4845 Issued in AZ
Practice address
6136 Lake Murray Blvd
La Mesa, CA 91942-2502
Phone
(619) 303-5500
NPI assigned
Apr 28, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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 4845 AZ Primary

Addresses

Primary practice location

6136 Lake Murray Blvd
La Mesa, CA 91942-2502

Mailing address

6136 Lake Murray Blvd
La Mesa, CA 91942-2502
Phone (619) 303-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20110615000548 AZ Practitioner - Physician Assistant 3577740711 Reassigns benefits to 2 organizations
I20180320001126 CA Practitioner - Physician Assistant 3577740711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Truecare Urgent Care LLCGroup PAC ID 3173951514, 10 clinicians

Practice addresses (Care Compare)

2035 Mesquite Ave
Suite a
Lake Havasu City, AZ 86403-5894
Phone (928) 846-4343

Merit-based Incentive Payment System (MIPS)

Final score
22.62 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4845AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marque Medical Clinic, Inc CurrentSince Feb 10, 2018 Accepting new patients
Nextcare Arizona I JV LLC Current Accepting new patients
Burt Faibisoff, MD, PLLC Past Accepting new patients

Locations

2080 W Southern Ave
Bldg A1
Apache Junction, AZ 85120
Phone (480) 985-0172

450 S Willard St
Ste 120
Cottonwood, AZ 86326
Phone (928) 634-2574

1000 N Humphreys St
Ste 104
Flagstaff, AZ 86001
Phone (928) 779-3844

1810 Mesquite Ave
Ste B
Lk Havasu Cty, AZ 86403
Phone (928) 453-4600

914 N Scottsdale Rd
Ste 104
Tempe, AZ 85288
Phone (480) 776-1620

9525 E Old Spanish Trl
Ste 101
Tucson, AZ 85748
Phone (520) 731-3666

1394 W 16th St
Yuma, AZ 85364
Phone (928) 539-0055

2075 San Joaquin Hills Rd
Newport Beach, CA 92660
Phone (877) 693-6266

4490 Fanuel St
Ste 100
San Diego, CA 92109

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.

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1265723985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 LAKE MURRAY BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422502",
            "telephone_number": "619-303-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 LAKE MURRAY BLVD",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422502",
            "telephone_number": "619-303-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERSHON",
        "first_name": "LES",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-28",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.