Individual provider Active NPI

Michael Ford Tikson, DSC, PA-C

  • Physician Assistant
  • Lemoore, CA
National Provider Identifier
1578029666
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12882063-1206 Issued in UT
Practice address
937 Franklin Blvd
Lemoore, CA 93246-4700
Phone
(559) 998-4441
NPI assigned
Feb 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12882063-1206 UT Primary
Military Health Care Provider 171000000X

Addresses

Primary practice location

937 Franklin Blvd
Lemoore, CA 93246-4700

Mailing address

937 Franklin Blvd
Lemoore, CA 93246-4700
Phone (559) 998-4441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230911001865 TX Order and Referring Only - Physician Assistant 9537523493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1578029666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 FRANKLIN BLVD",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932464700",
            "telephone_number": "559-998-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 FRANKLIN BLVD",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932464700",
            "telephone_number": "559-998-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIKSON",
        "first_name": "MICHAEL",
        "middle_name": "FORD",
        "credential": "DSC, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12882063-1206",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoore, CA

Sources for this page

Verify at the official NPI Registry.