Ana D Rubalcaba, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA22007 Issued in CA

Practice address

8110 Mango Ave
Fontana, CA 92335-3603

Phone

(909) 822-1164

NPI assigned

Feb 7, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group
• Pinnacle Medical Group, Inc

  dba Optum

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1376876912
  Medicare reassignment NPD
• Pinnacle Medical Group, Inc

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1043255763
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD
• Dignity Health

  dba St. Bernardine Medical Center

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  NPD (past)
• Pinnacle Medical Group, Inc.

  • Family Medicine Physician
  • San Bernardino, CA
  • NPI 1447292248
  NPD (past)
• United Family Care

  • Internal Medicine Physician
  • Fontana, CA
  • NPI 1629027255
  NPD (past)

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1821360702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12209",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924232209",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 MANGO AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353603",
            "telephone_number": "909-822-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBALCABA",
        "first_name": "ANA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22007",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Royal R. Reliable Transportation Services LLC (Royal R. Reliable Transportion Services LLC)
• Royals' LCSW Therapeutic Services, Inc
• Chelsea Royer, MD
• RR Quality Management Inc
• Joseph H. Ruan, M.D.
• Elisabet Rubalcava
• Aaron L. Rubin, MD
• Nadine Rubio, MFTI
• Itzel Brianna Ruelas
• Jeanette Ruffocerda

• Medical Physician Assistant in Fontana, CA
• Providers in Fontana, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.