Individual provider Active NPI

Erin L Gysbers, P.A.-C

  • Physician Assistant
  • Redlands, CA
National Provider Identifier
1386800860
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 19325 Issued in CA
Practice address
2 W Fern Ave
Redlands, CA 92373
Phone
(909) 793-3311
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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 PA 19325 CA Primary

Addresses

Primary practice location

2 W Fern Ave
Redlands, CA 92373

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 355-4188

Other practice location 1

900 E Washington St Ste 200
Colton, CA 92324-4192
Phone (909) 882-5867

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
I20130402000127 CA Practitioner - Physician Assistant 5395773089 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19325CAMDPhysical Therapist
PA 19325CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Jan 12, 2013 Accepting new patients
Beaver Medical Group P C CurrentSince Jan 12, 2013 Accepting new patients

Locations

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

Interoperability endpoints

  • Direct secure messaging: erin.gysbers@1174.chartlogic.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1386800860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-355-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W FERN AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-793-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 E Washington St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923244192",
            "country_code": "US",
            "telephone_number": "909-882-5867",
            "fax_number": "909-503-1913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GYSBERS",
        "first_name": "ERIN",
        "middle_name": "L",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 19325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.