Charles Ike, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13851 Issued in CA

Practice address

815 Dr Martin Luther King Jr Blvd
Bakersfield, CA 93307-1365

Phone

(661) 322-3905

Fax

(661) 322-1370

NPI assigned

Aug 17, 2006

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, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinica Sierra VistaGroup PAC ID 3870407505, 180 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: charles.ike@2871.securemail.prognocis.com
• Direct secure messaging: cike20102@clinicasierravista.direct-ci.com

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.

• Clinica Sierra Vista

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1861494338
  Medicare reassignment Care Compare group NPD
• Clinica Sierra Vista

  • Community/Retail Pharmacy
  • Lamont, CA
  • NPI 1275161325
  NPD
• Bakersfield Memorial Hospital

  • Institutional Pharmacy
  • Bakersfield, CA
  • NPI 1144256363
  NPD (past)
• Central California Emergency Medicine Physicians

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1265546451
  NPD (past)
• Clinica Sierra Vista

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1245234673
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1366555799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 DR MARTIN LUTHER KING JR BLVD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933071365",
            "telephone_number": "661-322-3905",
            "fax_number": "661-322-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 DR MARTIN LUTHER KING JR BLVD",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933071365",
            "telephone_number": "661-322-3905",
            "fax_number": "661-322-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKE",
        "first_name": "CHARLES",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Olusola Adebowale Ilori
• James J Im, MD

• Physician Assistant in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.