Active NPI
Donna Lynn Pryor, PA-C
- Surgical Physician Assistant
- Modesto, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 1324 Nelson Ave. Suite B
Modesto, CA 95350 - Phone
- (209) 524-9481
- Fax
- (209) 524-9486
- NPI assigned
- Feb 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Primary | ||
| Physician Assistant | 363A00000X | PA 14350 | CA |
Addresses
Primary practice location
1324 Nelson Ave. Suite B
Modesto, CA 95350
Mailing address
542 Sagewalk Court
Oakdale, CA 95361
Phone (209) 988-0943
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1324 Nelson Ave
Modesto, CA 95350-5374
Phone (209) 524-9481
355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.15 of 100
- Promoting interoperability
- 99
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 14350 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden State Dermatology Associates, Inc. | Current | Accepting new patients |
Locations
1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510
1324 Nelson Ave
Ste B
Modesto, CA 95350
Phone (209) 524-9481
1425 W H St
Ste 380
Oakdale, CA 95361
Phone (209) 524-9481
355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704
370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592
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.
-
- Dermatology Physician
- Walnut Creek, CA
- NPI 1700860871
-
- Ambulatory Surgical Clinic/Center
- Fresno, CA
- NPI 1235738576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1639145386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "542 SAGEWALK COURT",
"city": "OAKDALE",
"state": "CA",
"postal_code": "95361",
"telephone_number": "209-988-0943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1324 NELSON AVE. SUITE B",
"city": "MODESTO",
"state": "CA",
"postal_code": "95350",
"telephone_number": "209-524-9481",
"fax_number": "209-524-9486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYOR",
"first_name": "DONNA",
"middle_name": "LYNN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA 14350",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.