Anthoney Jawaun Paulisich, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

63692 Issued in CA

Practice address

3425 N 1St St
Fresno, CA 93726-6821

Phone

(559) 608-6581

NPI assigned

Jan 10, 2020

Last updated

Dec 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

University of California, Davis School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Dreams Medical Corporation PCGroup PAC ID 7113353160, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• California Dreams Medical Corporation PC

  dba American Family Care

  • Urgent Care Clinic/Center
  • Fresno, CA
  • NPI 1487299699
  Medicare reassignment Care Compare group NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744
  Medicare reassignment
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
  • NPI 1114407244
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Ivanhoe, CA
  • NPI 1386670610
  NPD (past)
• Occupational Health Centers of California, a Medical Corporation

  • Occupational Medicine Clinic/Center
  • Livingston, CA
  • NPI 1104457662
  NPD (past)

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1821638420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266821",
            "telephone_number": "559-608-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266821",
            "telephone_number": "559-608-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULISICH",
        "first_name": "ANTHONEY",
        "middle_name": "JAWAUN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-10",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desmond Paul-Coker, D.O.
• Landi Paul
• Simon Paul, MD
• Pauline Family Dental Care (Nimfa C. Nadores)
• Robert C Pauline, PT, MPT
• Heather Paulissen, RDN, CSO
• Michael David Paulissen, R.D.
• Robert Milton Paull, MD
• Erin Paulsen, BCBA
• Pavel S. Volkov, M.D. Inc.

• Physician Assistant in Fresno, CA
• Providers in Fresno, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.