Clinton Earl Prescott Jr., M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A25653 Issued in CA

Practice address

296 Cottage Ave
Manteca, CA 95336-4942

Phone

(209) 239-2901

Fax

(209) 239-8662

NPI assigned

Sep 13, 2006

Last updated

Apr 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Texas Medical Branch at Galveston, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Artius Dermatology Associates PCGroup PAC ID 6305126780, 17 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Artius Dermatology Associates, P.C.

  dba Lux Dermatology

  • Dermatology Physician
  • Hanford, CA
  • NPI 1245782291
  Medicare reassignment Care Compare group NPD
• Chico Dermatology Inc

  • Dermatology Physician
  • Chico, CA
  • NPI 1578121570
  Medicare reassignment NPD
• Sol Dermatology Associates

  • Dermatology Physician
  • Santa Barbara, CA
  • NPI 1164391959
  Medicare reassignment NPD
• Community Hospice, Inc.

  • Community Based Hospice Care Agency
  • Modesto, CA
  • NPI 1043326531
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1457456584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 COTTAGE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364942",
            "telephone_number": "209-239-2901",
            "fax_number": "209-239-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 COTTAGE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364942",
            "telephone_number": "209-239-2901",
            "fax_number": "209-239-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "CLINTON",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A25653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A256532",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prabhjit S. Purewal, MD, Inc
• Prabhjit S. Purewal, MD, Inc.
• Prabhjit S. Purewal, MD, Inc.
• Araceli Hernandez Prado
• Elizabeth Preciado
• Dajea Price
• Prime Path Medical Transport LLC
• Carolyn Przybyla
• Iona A Puchta, COTA
• David T. Quach, MD

• Dermatology Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.