Individual provider Active NPI

Sean Easton, PA

  • Physician Assistant
  • Vista, CA
National Provider Identifier
1790284131
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
145 Thunder Dr
Vista, CA 92083-6010
Phone
(760) 941-9002
Fax
(760) 805-0421
NPI assigned
Feb 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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 Primary

Addresses

Primary practice location

145 Thunder Dr
Vista, CA 92083-6010

Mailing address

145 Thunder Dr
Vista, CA 92083-6010

Other identifiers 2

IdentifierTypeStateIssuer
6981OtherAZSTATE LICENSE
58687OtherCASTATE LICENSE

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
I20230210000768 CA Practitioner - Physician Assistant 6002178803 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58687CAMDDentist
6981AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Mar 1, 2023 Accepting new patients
Beaver Medical Group P C CurrentSince Mar 1, 2023 Accepting new patients

Locations

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

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

Interoperability endpoints

  • Direct secure messaging: northcountytraumaassociates.seaneaston@158576.advancedmd-direct.com
  • Direct secure messaging: sean.easton.p1@direct.monarchhealthcare.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1518307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1790284131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 THUNDER DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836010",
            "fax_number": "760-805-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 THUNDER DR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836010",
            "telephone_number": "760-941-9002",
            "fax_number": "760-805-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTON",
        "first_name": "SEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-11",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6981",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "58687",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.