Individual provider Active NPI

Bianca Nicole Reynoso

  • Physician Assistant
  • Tulare, CA
National Provider Identifier
1801670120
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1134 E Cartmill Ave
Tulare, CA 93274-9610
Phone
(559) 686-9097
NPI assigned
Aug 21, 2023
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

1134 E Cartmill Ave
Tulare, CA 93274-9610

Mailing address

1134 E Cartmill Ave
Tulare, CA 93274-9610
Phone (559) 686-9097

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
I20241218002887 CA Practitioner - Physician Assistant 2466899323 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63795CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Altura Centers for Health CurrentSince Dec 1, 2024 Accepting new patients
A.T. Still University - College for Healthy Communities PastSince Sep 14, 2025 Accepting new patients

Locations

1101 N Cherry St
Tulare, CA 93274
Phone (559) 686-9097

1134 E Cartmill Ave
Tulare, CA 93274
Phone (559) 686-9097

Interoperability endpoints

  • Direct secure messaging: bianca.reynoso.p1@direct.altura.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, 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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1801670120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 E CARTMILL AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932749610",
            "telephone_number": "559-686-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 E CARTMILL AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932749610",
            "telephone_number": "559-686-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSO",
        "first_name": "BIANCA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulare, CA

Sources for this page

Verify at the official NPI Registry.