Individual provider Active NPI

Kevin Fryer

  • Physician Assistant
  • Corona, CA
National Provider Identifier
1295467447
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61581 Issued in CA
Practice address
341 Magnolia Ave Ste 101
Corona, CA 92879-3331
Phone
(951) 735-6060
Fax
(951) 735-4510
NPI assigned
Jun 27, 2022
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 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 61581 CA Primary

Addresses

Primary practice location

341 Magnolia Ave Ste 101
Corona, CA 92879-3331

Mailing address

15101 Fairfield Ranch Rd Unit 14303
Chino Hills, CA 91709-8891
Phone (480) 628-2692

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
I20230209001101 CA Practitioner - Physician Assistant 5193197671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corona Orthopaedic Associates Medical Group IncGroup PAC ID 0547243586, 11 clinicians

Practice addresses (Care Compare)

341 Magnolia Ave
Corona, CA 92879-3331
Phone (209) 334-6583

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.87 of 100Reported as group
Quality
46.3
Improvement activities
40
Cost
81.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61581CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kfryer587953@direct.llu.edu

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 3

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1295467447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15101 FAIRFIELD RANCH RD UNIT 14303",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917098891",
            "telephone_number": "480-628-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 MAGNOLIA AVE STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793331",
            "telephone_number": "951-735-6060",
            "fax_number": "951-735-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYER",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.