Individual provider Active NPI

Joshua Powers

  • Physician Assistant
  • Victorville, CA
National Provider Identifier
1790202141
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55029 Issued in CA
Practice address
12550 Hesperia Rd Ste 101
Victorville, CA 92395
Phone
(760) 381-7703
NPI assigned
Aug 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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 PA55029 CA Primary

Addresses

Primary practice location

12550 Hesperia Rd Ste 101
Victorville, CA 92395

Mailing address

15875 Jericho Way
Victorville, CA 92394-6771
Phone (801) 560-6616

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address urgentcaresmhd@sjhhandhmg.allscriptsdirect.net

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
I20171128002727 CA Practitioner - Physician Assistant 9739446865 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Loma Linda University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

12550 Hesperia Rd
Suite 100
Victorville, CA 92395-5873
Phone (760) 241-6666

18300 US Hwy 18
Apple Valley, CA 92307-2206
Phone (760) 242-2311

18310 US Hwy 18
Apple Valley, CA 92307-2206

19333 Bear Valley Rd
Apple Valley, CA 92308-5149

Hospital & facility affiliations

  • Barstow Community Hospital Hospital, Barstow, CA, CCN 050298

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA55029CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 1, 2017 Accepting new patients
Cep America - California CurrentSince Aug 1, 2018 Accepting new patients
Providence Medical Foundation CurrentSince Nov 1, 2017 Accepting new patients

Locations

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

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

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1790202141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15875 JERICHO WAY",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923946771",
            "telephone_number": "801-560-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA RD STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-381-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-26",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urgentcaresmhd@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "12550 Hesperia Rd Ste 101",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.