Individual provider Active NPI

Eric Hixon, PA

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1841276409
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16542 Issued in CA
Practice address
77 Casa St
201
San Luis Obispo, CA 93405-5803
Phone
(805) 269-1500
Fax
(805) 269-1585
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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 PA16542 CA Primary

Addresses

Primary practice location

77 Casa St
201
San Luis Obispo, CA 93405-5803

Mailing address

2050 S Blosser Rd
Santa Maria, CA 93458-7310
Phone (805) 361-8028

Other identifiers 1

IdentifierTypeStateIssuer
PA165420MedicaidCA

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
I20041026000683 CA Practitioner - Physician Assistant 5294796819 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16542CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Physician Partners CurrentSince Aug 3, 2015 Accepting new patients
First Choice Physician Partners CurrentSince Aug 3, 2015 Accepting new patients
Pacific Psychiatry Inc., a Professional Medical Corporation Past Accepting new patients

Locations

1325 N Rose Dr
Ste 100
Placentia, CA 92870
Phone (714) 729-0103

Interoperability endpoints

  • Direct secure messaging: eric.hixon.1@17363.direct.athenahealth.com

Organizations & group practices 4

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1841276409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S BLOSSER RD",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934587310",
            "telephone_number": "805-361-8028",
            "fax_number": "805-361-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "address_2": "201",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-269-1500",
            "fax_number": "805-269-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIXON",
        "first_name": "ERIC",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA165420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.