Individual provider Active NPI

Elias Zayer, PA-C

  • Physician Assistant
  • Rancho Cucamonga, CA
National Provider Identifier
1649903758
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61308 Issued in CA
Practice address
11398 Kenyon Way Ste J
Rancho Cucamonga, CA 91701-9229
Phone
(909) 727-3911
NPI assigned
Jul 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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 61308 CA Primary

Addresses

Primary practice location

11398 Kenyon Way Ste J
Rancho Cucamonga, CA 91701-9229

Mailing address

PO Box 2041
Rancho Cucamonga, CA 91729-2041
Phone (909) 418-4765

Other practice location 1

7552 Classico Pl
Rancho Cucamonga, CA 91739-9415
Phone (909) 418-4765

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61308CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lani City Medical Specialty CurrentSince Oct 6, 2024 Accepting new patients
Lani City Medical CurrentSince Aug 7, 2022 Accepting new patients

Locations

11398 Kenyon Way
Ste J
Rch Cucamonga, CA 91701
Phone (909) 527-0266

Interoperability endpoints

  • Direct secure messaging: elias.zayer.1@18340.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1649903758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2041",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917292041",
            "telephone_number": "909-418-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11398 KENYON WAY STE J",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917019229",
            "telephone_number": "909-727-3911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7552 Classico Pl",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917399415",
            "country_code": "US",
            "telephone_number": "909-418-4765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAYER",
        "first_name": "ELIAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.