Jason Aquino Buranday, PA-C
Individual provider Active NPI Physician Assistant · Arroyo Grande, CA
NPI 1609030683 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1609030683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA19820 (CA)
- Practice address
- 860 Oak Park Blvd
Suite 101
Arroyo Grande, CA 93420-1800 - Phone
- (805) 481-3685
- Fax
- (805) 481-5245
- NPI assigned
- Jul 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Southern California Keck School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000
Hospital & facility affiliations
- Kaiser Foundation Hospital - West la
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131112001156 | CA | Practitioner - Physician Assistant | 0840358354 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA19820 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Arroyo Grande Surgical Institute, LLC | Past |
Accepting new patients |
Locations
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA19820 | CA | Yes |
Addresses
Primary practice location
860 Oak Park Blvd
Suite 101
Arroyo Grande, CA 93420-1800
Mailing address
860 Oak Park Blvd
Suite 101
Arroyo Grande, CA 93420-1800
Phone (805) 481-3685
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Arroyo Grande, CA
- Mark Brostman
- Deanna Marie Brown
- Browne Psychological Services, LLC
- Shelly A. Browne
- Mary Anne Bruggeman
- Sara Kane Burt
- Elaine Kathryn Bynum
- Daniel William Cable
- Maria Regina Camberos Rios
- Jerilynn Ford Campbell
All providers in Arroyo Grande, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.