Individual provider Active NPI

Daniel Perry, PA-C

  • Surgical Physician Assistant
  • Arroyo Grande, CA
National Provider Identifier
1710352083
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
53948 Issued in CA
Practice address
880 Oak Park Blvd Ste 201
Arroyo Grande, CA 93420-1821
Phone
(805) 473-8346
NPI assigned
Dec 11, 2015
Last updated
Jan 26, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 53948 CA Primary

Addresses

Primary practice location

880 Oak Park Blvd Ste 201
Arroyo Grande, CA 93420-1821

Mailing address

11525 Piona LN
Atascadero, CA 93422-6043
Phone (805) 462-8334

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
I20170228002553 CA Practitioner - Physician Assistant 4981988466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Spa Med IncGroup PAC ID 9830567189, 8 clinicians

Practice addresses (Care Compare)

120 N Miller St
Suite C
Santa Maria, CA 93454-4557
Phone (805) 739-0033

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley S Kurgis D O Inc PastSince May 2, 2011 Accepting new patients
Twin Cities Community Hospital, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1710352083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 PIONA LN",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934226043",
            "telephone_number": "805-462-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 OAK PARK BLVD STE 201",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934201821",
            "telephone_number": "805-473-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-11",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "53948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

Verify at the official NPI Registry.