Individual provider Active NPI

Jason Alan Berryhill, PA-C

  • Medical Physician Assistant
  • Auburn, CA
National Provider Identifier
1497191993
Registry record updated May 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA22877 Issued in CA
Practice address
13555 Bowman Rd
Suite 100
Auburn, CA 95603-3156
Phone
(530) 885-3951
NPI assigned
May 12, 2013
Last updated
May 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA22877 CA Primary

Addresses

Primary practice location

13555 Bowman Rd
Suite 100
Auburn, CA 95603-3156

Mailing address

1410 Lorimer Way
Roseville, CA 95747-6036
Phone (209) 534-6301

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
I20160601000264 CA Order and Referring Only - Physician Assistant 0941590186

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Floyd C David Professional CorporationGroup PAC ID 4385124403, 2 clinicians

Practice addresses (Care Compare)

1907 Douglas Blvd
Suite 70
Roseville, CA 95661-3808
Phone (916) 783-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA22877CAMDMedical Physician Assistant

Organizations & group practices 1

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": "1368316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368316800000",
    "number": "1497191993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 LORIMER WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476036",
            "telephone_number": "209-534-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 BOWMAN RD",
            "address_2": "SUITE 100",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033156",
            "telephone_number": "530-885-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRYHILL",
        "first_name": "JASON",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-12",
        "last_updated": "2013-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.