Individual provider Active NPI

Mark Ramos, P.A.

  • Physician Assistant
  • Northridge, CA
National Provider Identifier
1700829371
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17462 Issued in CA
Practice address
18300 Roscoe Blvd
Emergency Dept.
Northridge, CA 91325-4105
Phone
(818) 885-5396
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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 PA17462 CA Primary

Addresses

Primary practice location

18300 Roscoe Blvd
Emergency Dept.
Northridge, CA 91325-4105

Mailing address

P.O. Box 7802
Northridge, CA 91327
Phone (818) 523-1760

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050408000534 CA Practitioner - Physician Assistant 6901843242 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17462CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Feb 22, 2016 Accepting new patients
Cep America - California CurrentSince Jun 1, 2014 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 22, 2016 Accepting new patients
Freeman Emergency Physicians Medical Group Past Accepting new patients
Grapevine Emergency Physicians Medical Group Inc Past Accepting new patients

Locations

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

1001 N Tustin Ave
Santa Ana, CA 92705
Phone (714) 835-3555

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Organizations & group practices 10

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1700829371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 7802",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91327",
            "telephone_number": "818-523-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 ROSCOE BLVD",
            "address_2": "EMERGENCY DEPT.",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "818-885-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "MARK",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.