Individual provider Active NPI

Jeffrey Wayne Rubio, PA-C

  • Physician Assistant
  • Visalia, CA
National Provider Identifier
1548665706
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52081 Issued in CA
Practice address
5400 W Hillsdale Ave
Visalia, CA 93291-8222
Phone
(559) 738-7544
Fax
(559) 738-7586
NPI assigned
Oct 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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 52081 CA Primary

Addresses

Primary practice location

5400 W Hillsdale Ave
Visalia, CA 93291-8222

Mailing address

5400 W Hillsdale Ave Ste 150
Visalia, CA 93291-8222
Phone (559) 738-7544

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
I20150512001490 CA Practitioner - Physician Assistant 4082933130 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52081CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Aug 15, 2022 Accepting new patients
Cep America-California CurrentSince Aug 15, 2022 Accepting new patients
Nes Western Group, a Professional Corporation CurrentSince May 11, 2020 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

Interoperability endpoints

  • Direct secure messaging: jeffrey.rubio.1@17661.direct.athenahealth.com

Organizations & group practices 5

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": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1548665706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 W HILLSDALE AVE STE 150",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932918222",
            "telephone_number": "559-738-7544",
            "fax_number": "559-738-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 W HILLSDALE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932918222",
            "telephone_number": "559-738-7544",
            "fax_number": "559-738-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIO",
        "first_name": "JEFFREY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-30",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.