Individual provider Active NPI

Allen Martin Phelps, PA-C, MPAS

  • Physician Assistant
  • Temecula, CA
National Provider Identifier
1275593816
Registry record updated Nov 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1056661 Issued in NU
Practice address
41715 Winchester Rd Ste 101
Temecula, CA 92590-4853
Phone
(951) 308-4451
NPI assigned
Mar 27, 2006
Last updated
Nov 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2024

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 1056661 NU Primary

Addresses

Primary practice location

41715 Winchester Rd Ste 101
Temecula, CA 92590-4853

Mailing address

41715 Winchester Rd Ste 101
Temecula, CA 92590-4853
Phone (951) 308-4451

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
I20141203000017 CA Practitioner - Physician Assistant 8527380559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Temecula Medical CorporationGroup PAC ID 8022394071, 2 clinicians

Practice addresses (Care Compare)

41715 Winchester Rd
Temecula, CA 92590-4853

41715 Winchester Rd
Suite 202
Temecula, CA 92590-4854
Phone (951) 296-0788

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Management Practice Physician Assistant Corporation Physician Assistant Current Accepting new patients
Valor Health Group Medical Corporation Current Accepting new patients
Responsible Medical Solutions Corp Past Accepting new patients
MDRS Spine & Sport, Inc Past Accepting new patients

Locations

41715 Winchester Rd
Ste 101
Temecula, CA 92590
Phone (858) 616-6400

41715 Winchester Rd
Ste 107
Temecula, CA 92590
Phone 9512522972217

41715 Winchester Rd
Ste 202
Temecula, CA 92590
Phone (951) 296-0788

Interoperability endpoints

  • Direct secure messaging: allen.phelps.1@24997.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731801600000",
    "number": "1275593816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41715 WINCHESTER RD STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904853",
            "telephone_number": "951-308-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41715 WINCHESTER RD STE 101",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925904853",
            "telephone_number": "951-308-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "ALLEN",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C, MPAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "1056661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.