Individual provider Active NPI

Ronald A Damiano, PA

  • Physician Assistant
  • Yuma, AZ
National Provider Identifier
1396826541
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2951 Issued in AZ
Practice address
1230 W 24TH St Ste 1
Yuma, AZ 85364
Phone
(928) 314-3702
Fax
(928) 314-4687
NPI assigned
Oct 17, 2006
Last updated
May 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 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 2951 AZ Primary

Addresses

Primary practice location

1230 W 24TH St Ste 1
Yuma, AZ 85364

Mailing address

1230 W 24TH St Ste 1
Yuma, AZ 85364-6232
Phone (928) 314-3702

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
I20220920001970 CA Practitioner - Physician Assistant 8729056767 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61507CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Sep 26, 2022 Accepting new patients
Community Medical Centers Inc CurrentSince Jun 19, 2023 Accepting new patients
Community Medical Centers Inc CurrentSince Jun 19, 2023 Accepting new patients
SCS Radiology Past Accepting new patients

Locations

7210 Murray Dr
Stockton, CA 95210
Phone (209) 373-2816

7912 West Ln
Ste 221
Stockton, CA 95210
Phone (209) 546-3870

730 N Central Ave
Tracy, CA 95376
Phone (209) 820-1500

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

Interoperability endpoints

  • Direct secure messaging: rdamiano768099@direct.ochin.org
  • Direct secure messaging: ronald.damiano.p1@direct.cmcentersinc.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1396826541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 W 24TH ST STE 1",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646232",
            "telephone_number": "928-314-3702",
            "fax_number": "928-314-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 W 24TH ST STE 1",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "928-314-3702",
            "fax_number": "928-314-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMIANO",
        "first_name": "RONALD",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.