NPIMap

Individual provider Active NPI

William Chamberlain

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1760857247
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53090 Issued in CA
Practice address
2515 W Pico Blvd
Los Angeles, CA 90006-4003
Phone
(213) 384-4555
Fax
(213) 382-9555
NPI assigned
Dec 9, 2015
Last updated
Oct 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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 53090 CA Primary

Addresses

Primary practice location

2515 W Pico Blvd
Los Angeles, CA 90006-4003

Mailing address

PO Box 1139
Bakersfield, CA 93302-1139
Phone (661) 371-2796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161019002040 CA Practitioner - Physician Assistant 1153614920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centric HealthGroup PAC ID 8729009030, 66 clinicians
Kern Neurosurgical Institute IncGroup PAC ID 7517197510, 4 clinicians

Practice addresses (Care Compare)

2901 Sillect Ave
Bakersfield, CA 93308-6372

5329 Office Ctr CT
Suite 110
Bakersfield, CA 93309-7400
Phone (661) 843-7880

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53090CAMDGeneral Practice Dentistry

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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 6

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": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1760857247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1139",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933021139",
            "telephone_number": "661-371-2796",
            "fax_number": "661-438-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900064003",
            "telephone_number": "213-384-4555",
            "fax_number": "213-382-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-09",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.