Bryan Carter

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1455 E 3Rd Street
San Bernardino, CA 92410

Phone

(909) 382-7100

NPI assigned

Oct 9, 2015

Last updated

Oct 9, 2015By the provider in NPPES

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 TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bryan.carter.1@27715.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Su Clinica Familiar

  • Federally Qualified Health Center (FQHC)
  • Harlingen, TX
  • NPI 1285643304
  Medicare reassignment NPD

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1689045197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25590 PROSPECT AVE",
            "address_2": "APT 04B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E 3RD STREET",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92410",
            "telephone_number": "909-382-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "BRYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eduardo Guadalupe Carrizosa
• Robert Duncan Carruthers
• Mabel E Carson, FNP-C
• Carter Lane, D.D.S., M.S.
• Brittany Carter
• Joshua Wallace Cartter, D.D.S.
• Julia Carvajal
• Casa de San Bernardino
• Deina Casanova
• Elizabeth Casas-Valdovinos

• Medical Physician Assistant in San Bernardino, CA
• Providers in San Bernardino, 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 Oct 9, 2015; 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.