John T. Walsh, P.A., C.D.E.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11517 Issued in CA

Practice address

625 W Citracado Pkwy Suite 108
Escondido, CA 92025

Phone

(760) 743-1431

Fax

(760) 743-6455

NPI assigned

Sep 17, 2008

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• North County Endocrine Medical Group

  • Specialist
  • Escondido, CA
  • NPI 1013068105
  Medicare reassignment

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1386893089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W CITRACADO PKWY SUITE 108",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92025",
            "telephone_number": "760-743-1431",
            "fax_number": "760-743-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W CITRACADO PKWY SUITE 108",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92025",
            "telephone_number": "760-743-1431",
            "fax_number": "760-743-6455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28441 Rancho California Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925903618",
            "country_code": "US",
            "telephone_number": "951-699-4601",
            "fax_number": "760-743-6455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "JOHN",
        "middle_name": "T.",
        "credential": "P.A., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-17",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "11517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Lynn Walker, PA-C
• Brianna Wallace
• Walmart Inc.
• Walmart Inc.
• Jack Walsh
• Kathleen Walsh, NMW
• Jon Lars Walwick, D.C.
• Jennifer Ling Wang-Hall, PHD
• Chunyang Tracy Wang, MD
• Michael Wang

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.