John R Cercado, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16210 Issued in CA

Practice address

1700 Coffee Rd
Modesto, CA 95355-2803

Phone

(209) 526-4500

NPI assigned

Sep 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abidali Professional Medical IncGroup PAC ID 4486177748, 6 clinicians

Stat Med PC a California Medical Professional CorporationGroup PAC ID 1850528530, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Abidali Professional Medical Inc

  • Urgent Care Clinic/Center
  • Modesto, CA
  • NPI 1962224824
  Medicare reassignment Care Compare group NPD
• Stat Med PC a California Medical Professional Corporation

  • Urgent Care Clinic/Center
  • Lafayette, CA
  • NPI 1891132106
  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Folsom, CA
  • NPI 1578720124
  NPD
• Stat Med PC a California Medical Professional Corporation

  • Urgent Care Clinic/Center
  • Brentwood, CA
  • NPI 1265169643
  NPD

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1497940407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-526-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-526-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERCADO",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "13918",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Valley Therapeutic Alliance, Inc.
• Cep America - California
• Cep America - California
• Cep America - Psychiatry PC
• Cep America- Neurology, PC
• Karina Cercas
• Agustin Cerda
• Jacqueline Cerda
• Perla Cerna
• Gabriel Augusto Cerono, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.