Individual provider Active NPI

Grace Yomogida, PA

  • Physician Assistant
  • Brawley, CA
National Provider Identifier
1861278087
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63935 Issued in CA
Practice address
207 W Legion Road
Brawley, CA 92227-7780
Phone
(760) 351-3333
NPI assigned
Sep 4, 2023
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X CA
Physician Assistant 363A00000X 63935 CA Primary

Addresses

Primary practice location

207 W Legion Road
Brawley, CA 92227-7780

Mailing address

207 W Legion Rd
Brawley, CA 92227-7780

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
I20240228000687 CA Practitioner - Physician Assistant 1355786583 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bci OrthopaedicsGroup PAC ID 6608101464, 16 clinicians

Practice addresses (Care Compare)

23521 Paseo de Valencia
Suite 309
Laguna Hills, CA 92653-3144
Phone (949) 229-3500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Jan 17, 2024 Accepting new patients
Cep America-California CurrentSince Jan 17, 2024 Accepting new patients

Locations

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Interoperability endpoints

  • Direct secure messaging: gyomogida852522@direct.memorialcare.org

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1861278087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W LEGION ROAD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780",
            "telephone_number": "760-351-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOMOGIDA",
        "first_name": "GRACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-04",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

Verify at the official NPI Registry.