Robert Ray Witty, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 12064 Issued in CA

Practice address

12810 Heacock St
Suite B-206
Moreno Valley, CA 92553-2854

Phone

(951) 485-5155

Fax

(951) 485-5152

NPI assigned

Dec 28, 2006

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

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

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.

• Armando Franco MD Inc

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1629415120
  Medicare reassignment NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548326028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25634 SAN THOMAS ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925575845",
            "telephone_number": "951-924-8121",
            "fax_number": "951-243-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12810 HEACOCK ST",
            "address_2": "SUITE B-206",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925532854",
            "telephone_number": "951-485-5155",
            "fax_number": "951-485-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTY",
        "first_name": "ROBERT",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 12064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Grace Wirth
• Devi Sophia Wise, LCSW
• Wisr Ministries Inc. (Save Our Siblings)
• Amir Wissa
• Sarath C Witana, M.D.
• Gunnar Wolfe, MD
• Raquel Wolfe, MD
• Wolfpack ABA, LLC
• Hayley Womack
• Jonathan Patam Won

• Physician Assistant in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.