Nickolas Paul De Leon

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

58866 Issued in CA

Practice address

344 E 6TH St
Madera, CA 93638-3631

Phone

(559) 664-4000

Fax

(559) 675-5224

NPI assigned

May 19, 2019

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Camarena HealthGroup PAC ID 4880584317, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madera Community Hospital Hospital, Madera, CA, CCN 050856

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nickolas.de.leon.1@25900.direct.athenahealth.com

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.

• Camarena Health

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
  • NPI 1891778114
  Medicare reassignment Care Compare group NPD (past)
• Camarena Health

  dba Camarena Health - Los Banos

  • Federally Qualified Health Center (FQHC)
  • Los Banos, CA
  • NPI 1114757754
  NPD
• Camarena Health

  dba Camarena Health Cleveland Avenue

  • Federally Qualified Health Center (FQHC)
  • Madera, CA
  • NPI 1770141350
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Madera Community Hospital

  dba Family Health Services Rural Health Clinic

  • General Acute Care Hospital
  • Madera, CA
  • NPI 1669673646
  Care Compare affiliation

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

{
    "created_epoch": "1558224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1861058430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 E 6TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383631",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 E 6TH ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936383631",
            "telephone_number": "559-664-4000",
            "fax_number": "559-675-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "NICKOLAS",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-19",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "58866",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Zollinger Davis, D.O.
• Dawn Z Power Dental Inc
• Sherrie De Guzman
• Dawn Denise De la Mater Huxley, LMFT
• Marizela De la Torre
• Victoria De Leon
• Stephen A De Santis, MD
• Nancy Elizabeth Deanda
• Maximino Jamisola Decorion II
• Rachel Dehlan, MA, LMFT

• Medical Physician Assistant in Madera, CA
• Providers in Madera, 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 29, 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.