Individual provider Active NPI

Rick Anthony Nevarez, MSPA, PA-C

  • Physician Assistant
  • Chino, CA
National Provider Identifier
1538989462
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13115 Bay Meadow Ave
Chino, CA 91710-5957
Phone
(626) 665-9425
NPI assigned
Oct 15, 2024
Last updated
Oct 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 NU Primary

Addresses

Primary practice location

13115 Bay Meadow Ave
Chino, CA 91710-5957

Mailing address

13115 Bay Meadow Ave
Chino, CA 91710-5957
Phone (626) 665-9425

Other names 1

  • Ricky Anthony Nevarez Other name

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
I20250408002535 CA Practitioner - Physician Assistant 6507380896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Bariatric a Medical CorporationGroup PAC ID 3476607052, 12 clinicians

Practice addresses (Care Compare)

401 E Highland Ave
Suite 351
San Bernardino, CA 92404-3830
Phone (909) 475-8611

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65450CAMDPharmacist

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": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1538989462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13115 BAY MEADOW AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105957",
            "telephone_number": "626-665-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13115 BAY MEADOW AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105957",
            "telephone_number": "626-665-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVAREZ",
        "first_name": "RICK",
        "middle_name": "ANTHONY",
        "credential": "MSPA, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICKY",
            "last_name": "NEVAREZ",
            "middle_name": "ANTHONY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.