Alfonso Becerra Jr., PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA19493 Issued in CA

Practice address

17051 Sierra Lakes Pkwy
Fontana, CA 92336-1274

Phone

(909) 428-1800

Fax

(909) 428-0494

NPI assigned

Dec 21, 2007

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Emergency MedicineGroup PAC ID 8628128196, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1639314255
  Medicare reassignment Care Compare group
• Riverside Emergency Physicians Medical Group

  • Emergency Medicine Physician
  • Riverside, CA
  • NPI 1972539039
  Medicare reassignment
• Southern California Emergency Medicine

  dba Riverside Urgent Care La Sierra

  • Urgent Care Clinic/Center
  • Riverside, CA
  • NPI 1063191575
  NPD

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1275717506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17051 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361274",
            "telephone_number": "909-428-1800",
            "fax_number": "909-428-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17051 SIERRA LAKES PKWY",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361274",
            "telephone_number": "909-428-1800",
            "fax_number": "909-428-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRA",
        "first_name": "ALFONSO",
        "name_suffix": "Jr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-21",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikaela Bautista
• Monique Bautista, LCSW
• Veronica Bautista, DO
• Vicki Lynn Beane, OTR L
• Shonda Beard, ASW
• Azucena Becerra
• Adrianne C. Beck, MD
• Teresa Shanay Beckley, CRANIAL SPECIALIST
• Darian Jason Behseresht, MD
• Teresita C. Belamide, MD

• Medical Physician Assistant in Fontana, CA
• Providers in Fontana, 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 May 2, 2014; 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.