Individual provider Active NPI

Charles Asamaphand, PA

  • Physician Assistant
  • Sun City, CA
National Provider Identifier
1487329413
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60609 Issued in CA
Practice address
27190 Sun City Blvd
Sun City, CA 92586-5505
Phone
(951) 723-3806
NPI assigned
Aug 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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 PA60609 CA Primary

Addresses

Primary practice location

27190 Sun City Blvd
Sun City, CA 92586-5505

Mailing address

27190 Sun City Blvd
Sun City, CA 92586-5505
Phone (951) 723-3806

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
I20220303001180 CA Practitioner - Physician Assistant 7517351745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rancho Family Medical Group IncGroup PAC ID 6305741240, 112 clinicians

Practice addresses (Care Compare)

263 Church Ave
Chula Vista, CA 91910-2728
Phone (619) 422-1324

27190 Sun City Blvd
Menifee, CA 92586-5505
Phone (951) 676-4193

28780 Single Oak Dr
Temecula, CA 92590-5528
Phone (951) 676-4193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60609CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Regents of the University of California Past Accepting new patients

Organizations & group practices 3

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1487329413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27190 SUN CITY BLVD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925865505",
            "telephone_number": "951-723-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27190 SUN CITY BLVD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925865505",
            "telephone_number": "951-723-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASAMAPHAND",
        "first_name": "CHARLES",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-11",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, CA

Sources for this page

Verify at the official NPI Registry.