Individual provider Active NPI

Jonathan Rice, PAC

  • Surgical Physician Assistant
  • Thousand Oaks, CA
National Provider Identifier
1720113392
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA16576 Issued in CA
Practice address
558 Saint Charles Dr Ste 200
Thousand Oaks, CA 91360-3968
Phone
(805) 379-2322
Fax
(805) 379-2373
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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 PA16576 CA Primary

Addresses

Primary practice location

558 Saint Charles Dr Ste 200
Thousand Oaks, CA 91360-3968

Mailing address

558 Saint Charles Dr Ste 200
Thousand Oaks, CA 91360-3968
Phone (805) 379-2322

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
I20040329001025 CA Practitioner - Physician Assistant 9638061054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Charles Spine InstituteGroup PAC ID 5496036550, 6 clinicians
Erik C Spayde MD IncGroup PAC ID 8527061928, 4 clinicians

Practice addresses (Care Compare)

1001 Newbury Rd
Thousand Oaks, CA 91320-6434
Phone (805) 379-2322

558 Saint Charles Dr
Suite 200
Thousand Oaks, CA 91360-3968
Phone 8053792322119

Hospital & facility affiliations

  • Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549

Merit-based Incentive Payment System (MIPS)

Final score
81.76 of 100Reported as group
Quality
90.68
Improvement activities
40
Cost
51.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16576CAMDAcupuncturist
PA16576CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Spine Institute CurrentSince Jun 1, 2025 Accepting new patients
Corona Orthopaedic Associates Medical Group Inc Past Accepting new patients

Locations

558 Saint Charles Dr
Ste 200
Thousand Oaks, CA 91360
Phone (805) 379-2322

1001 Newbury Rd
Thousand Oaks, CA 91320
Phone (805) 375-7900

Organizations & group practices 3

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.

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1720113392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 SAINT CHARLES DR STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603968",
            "telephone_number": "805-379-2322",
            "fax_number": "805-379-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 SAINT CHARLES DR STE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603968",
            "telephone_number": "805-379-2322",
            "fax_number": "805-379-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICE",
        "first_name": "JONATHAN",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA16576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.