Active NPI
Patrick R. Duke, PA-C
- Physician Assistant
- West Covina, CA
National Provider Identifier
1619990447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 11072
- Practice address
- 1050 Lakes Dr
Suite 100
West Covina, CA 91790-2924 - Phone
- (626) 918-6655
- Fax
- (626) 918-6633
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 11072 | CA | Primary |
Addresses
Primary practice location
1050 Lakes Dr
Suite 100
West Covina, CA 91790-2924
Mailing address
1050 Lakes Dr
Suite 100
West Covina, CA 91790-2924
Phone (626) 918-6655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11072 | CA | MD | Physical Therapist |
| PA 11072 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Medical Group | Past | Accepting new patients | |
| Orthopaedic Medical Group & Athletic Rehabilitation Center, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
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- West Covina, CA
- NPI 1174683643
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265155200000",
"number": "1619990447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 LAKES DR",
"address_2": "SUITE 100",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902924",
"telephone_number": "626-918-6655",
"fax_number": "626-918-6633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 LAKES DR",
"address_2": "SUITE 100",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902924",
"telephone_number": "626-918-6655",
"fax_number": "626-918-6633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUKE",
"first_name": "PATRICK",
"middle_name": "R.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2010-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 11072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.