Individual provider Active NPI

David S Emery, P.A.

  • Medical Physician Assistant
  • Highland, CA
National Provider Identifier
1780602318
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA11255 Issued in CA
Practice address
7000 Boulder Ave
Highland, CA 92346-3348
Phone
(909) 862-1191
NPI assigned
Jul 18, 2006
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04090 NC
Medical Physician Assistant 363AM0700X PA11255 CA Primary

Addresses

Primary practice location

7000 Boulder Ave
Highland, CA 92346-3348

Mailing address

PO Box 10069
Unit a
San Bernardino, CA 92423-0069
Phone (909) 335-4188

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
I20081223000071 CA Practitioner - Physician Assistant 7719049907 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-04090NCMDPhysician Assistant
PA11255CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Apr 15, 2015 Accepting new patients
Beaver Medical Group P C CurrentSince Apr 15, 2015 Accepting new patients

Locations

7000 Boulder Ave
Highland, CA 92346

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 583-2741

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1780602318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "address_2": "UNIT A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 BOULDER AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463348",
            "telephone_number": "909-862-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERY",
        "first_name": "DAVID",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04090",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA11255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, CA

Sources for this page

Verify at the official NPI Registry.