Individual provider Active NPI

Emmanuel Sawaya, PA-C

  • Physician Assistant
  • Ontario, CA
National Provider Identifier
1306074802
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20007 Issued in CA
Practice address
403 W F St
Ontario, CA 91762-3207
Phone
(909) 988-3288
Fax
(909) 988-6767
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 PA20007 CA Primary

Addresses

Primary practice location

403 W F St
Ontario, CA 91762-3207

Mailing address

403 W F St
Ontario, CA 91762-3207
Phone (909) 988-3288

Other identifiers 1

IdentifierTypeStateIssuer
PA20007OtherCAMEDICAL LICENSE

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
I20140904002223 CA Practitioner - Physician Assistant 5092933077 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20007CAMDAddiction (Substance Use Disorder) Counselor
PA20007CAMDPhysician Assistant

Organizations & group practices 3

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306074802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W F ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623207",
            "telephone_number": "909-988-3288",
            "fax_number": "909-988-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W F ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917623207",
            "telephone_number": "909-988-3288",
            "fax_number": "909-988-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWAYA",
        "first_name": "EMMANUEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA20007",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.