Robert Mark Pekari, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

18510 Issued in CA

Practice address

483 N Aviation Blvd
61St Medical Group/SGPF
El Segundo, CA 90245-2808

Phone

(310) 653-6676

NPI assigned

Nov 7, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1679554786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD",
            "address_2": "61ST MEDICAL GROUP/SGPF",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 N AVIATION BLVD",
            "address_2": "61ST MEDICAL GROUP/SGPF",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452808",
            "telephone_number": "310-653-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEKARI",
        "first_name": "ROBERT",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "18510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Pazurek
• Daniel Pearce
• Avik Peddi
• Mayely Pedraza Gonzalez
• Makayla Pegel
• Andrea Pelayo
• Larissa Pelayo
• Alexandra Pena
• Francisca Pena
• Isaac Pena

• Medical Physician Assistant in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.