Individual provider Active NPI

David Aaron Hustosky, PA-C

  • Physician Assistant
  • Poway, CA
National Provider Identifier
1275509473
Registry record updated Aug 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15038 Issued in CA
Practice address
15611 Pomerado Rd
Poway, CA 92064-2437
Phone
(858) 675-3100
NPI assigned
Feb 27, 2006
Last updated
Aug 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15038 CA Primary

Addresses

Primary practice location

15611 Pomerado Rd
Poway, CA 92064-2437

Mailing address

PO Box 28199
San Diego, CA 92198-0199
Phone (858) 613-8900

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
I20071120000479 CA Practitioner - Physician Assistant 6406944784 Reassigns benefits to 1 organization

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
Arch Health Partners IncGroup PAC ID 9931239027, 141 clinicians

Practice addresses (Care Compare)

15611 Pomerado Rd
Poway, CA 92064-2437
Phone (858) 675-3100

15611 Pomerado Rd
Suite 525
Poway, CA 92064-2439
Phone (858) 485-0050

2125 Citracado Pkwy
Escondido, CA 92029-4159

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15038CAMDOptometrist
PA15038CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Clinic Medical Group Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186704000000",
    "number": "1275509473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28199",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921980199",
            "telephone_number": "858-613-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "858-675-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTOSKY",
        "first_name": "DAVID",
        "middle_name": "AARON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2007-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.