Individual provider Active NPI

Daniel L Eustace, P.A.-C.

  • Physician Assistant
  • Los Banos, CA
National Provider Identifier
1801825195
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
54524 Issued in CA
Practice address
311 W I St
Los Banos, CA 93635
Phone
(209) 826-2222
NPI assigned
Jul 1, 2006
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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 C02993 MD
Physician Assistant 363A00000X 54524 CA Primary

Addresses

Primary practice location

311 W I St
Los Banos, CA 93635

Mailing address

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-2222

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-6406

Other practice location 2

1734 Valeria St
Dos Palos, CA 93620
Phone (267) 524-7390

Other practice location 3

311 W I St
Los Banos, CA 93635-3479
Phone (209) 826-6444

Other practice location 4

400 W I St Ste A
Los Banos, CA 93635-3459
Phone (209) 827-9999

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
I20220511000583 CA Practitioner - Physician Assistant 0749236438 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54524CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health CurrentSince May 4, 2022 Accepting new patients
Camarena Health CurrentSince May 4, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Johns Hopkins University Past Accepting new patients

Locations

1159 Country Club Dr
Madera, CA 93638

760 E Almond Ave
Madera, CA 93637

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

Interoperability endpoints

  • Direct secure messaging: daniel.eustace.1@25900.direct.athenahealth.com

Organizations & group practices 5

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1801825195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353479",
            "telephone_number": "209-826-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "93635",
            "telephone_number": "209-826-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-6406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1734 Valeria St",
            "address_purpose": "LOCATION",
            "city": "Dos Palos",
            "state": "CA",
            "postal_code": "93620",
            "country_code": "US",
            "telephone_number": "267-524-7390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "311 W I St",
            "address_purpose": "LOCATION",
            "city": "Los Banos",
            "state": "CA",
            "postal_code": "936353479",
            "country_code": "US",
            "telephone_number": "209-826-6444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W I St Ste A",
            "address_purpose": "LOCATION",
            "city": "Los Banos",
            "state": "CA",
            "postal_code": "936353459",
            "country_code": "US",
            "telephone_number": "209-827-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUSTACE",
        "first_name": "DANIEL",
        "middle_name": "L",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C02993",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.