Individual provider Active NPI

Ron Frank Poli, P.A.

  • Medical Physician Assistant
  • Anderson, CA
National Provider Identifier
1285839449
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2760 N. Balls Ferry Rd.
Anderson, CA 96007-3537
Phone
(530) 365-4412
Fax
(530) 365-5186
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 12356 CA
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

2760 N. Balls Ferry Rd.
Anderson, CA 96007-3537

Mailing address

2760 N. Balls Ferry Rd.
Anderson, CA 96007-3537
Phone (530) 365-4412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 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
I20150729010244 CA Practitioner - Physician Assistant 4486968823 Reassigns benefits to 4 organizations
I20151003000059 TX Practitioner - Physician Assistant 4486968823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 12356CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta Regional Medical Group, Inc CurrentSince Dec 28, 2018 Accepting new patients
County of Butte CurrentSince Jun 1, 2024 Accepting new patients
County of Butte CurrentSince Jun 1, 2024 Accepting new patients
Orna Gil MD Inc Current Accepting new patients
Rolling Hills Clinic Past Accepting new patients
Gateway Medical Center Inc Past Accepting new patients
John R. Munro M.D. Past Accepting new patients

Locations

3217 Cohasset Rd
Cohasset, CA 95973
Phone (530) 552-4578

995 Spruce St
Gridley, CA 95948
Phone (530) 846-7305

1355 East St
Ste 200
Redding, CA 96001
Phone (530) 229-2940

1100 Butte St
Redding, CA 96001
Phone (530) 227-6361

Interoperability endpoints

  • Direct secure messaging: ron.poli.p3@direct.smmg.nextgenshare.com
  • Direct secure messaging: ron.polipa.p1@direct.schc.nextgenshare.com

Organizations & group practices 11

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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1285839449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 N. BALLS FERRY RD.",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073537",
            "telephone_number": "530-365-4412",
            "fax_number": "530-365-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 N. BALLS FERRY RD.",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073537",
            "telephone_number": "530-365-4412",
            "fax_number": "530-365-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLI",
        "first_name": "RON",
        "middle_name": "FRANK",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 12356",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, CA

Sources for this page

Verify at the official NPI Registry.