Individual provider Active NPI

John W. Maruhn, P.A.

  • Physician Assistant
  • Jber, AK
National Provider Identifier
1639285836
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17943 Issued in CA
Practice address
5955 Zeamer Ave
Jber, AK 99506-3702
Phone
(907) 580-1545
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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 PA17943 CA Primary

Addresses

Primary practice location

5955 Zeamer Ave
Jber, AK 99506-3702

Mailing address

5955 Zeamer Ave
Jber, AK 99506-3702
Phone (907) 580-1545

Other identifiers 1

IdentifierTypeStateIssuer
PA17943OtherCAMEDI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250318000596 NC Practitioner - Physician Assistant 9739174194 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA17943CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Occupational Health P.C. CurrentSince Jan 31, 2025 Accepting new patients
Central California Emergency Medicine Physicians Past Accepting new patients
Emergency Medicine Associates P.a., P.C. Past Accepting new patients

Locations

1110 Kildaire Farm Rd
Cary, NC 27511
Phone (919) 481-0277

Organizations & group practices 3

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1639285836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995063702",
            "telephone_number": "907-580-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUHN",
        "first_name": "JOHN",
        "middle_name": "W.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "PA17943",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jber, AK

Sources for this page

Verify at the official NPI Registry.