John Batin, P.A.-C – Physician Assistant

Key facts

NPI: 1902017700
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: PA13442 (CA)
Practice address: 57675 29 Palms Hwy
Ste 111
Yucca Valley, CA 92284-3098
Phone: (760) 365-8500
Fax: (760) 365-8599
NPI assigned: May 24, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Yucca Family Medical Care, Inc. Family Medicine Physician · Yucca Valley, CA · NPI 1386820702

NPD (past)

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Yucca Family Medical Care, Inc. Primary Care Clinic/Center · Yucca Valley, CA · NPI 1942640511

CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · CORPORATE OFFICER · W-2 MANAGING EMPLOYEE

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facility	Type	Role	Since
Yucca Family Medical Care, Inc. Yucca Valley, CA · CCN 058976	Rural health clinic	5% Or Greater Direct Ownership Interest (49%) Corporate Officer (50%) W-2 Managing Employee (50%)	Jan 8, 2008 Jan 8, 2008 Jan 8, 2008

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20130513000076	CA	Order and Referring Only - Physician Assistant	4486732203

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
13442	CA	MD	Psychologist

Practice roles

Organization	Specialty	Status	New patients
Yucca Family Medical Care, Inc.		Past	Accepting new patients

Interoperability endpoints

FHIR API: https://fhir4.healow.com/fhir/r4/DCGCDA

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physician Assistant	363A00000X	PA13442	CA	Yes

Addresses

Primary practice location

57675 29 Palms Hwy
Ste 111
Yucca Valley, CA 92284-3098

Mailing address

P.O Box 1163
Yucca Valley, CA 92286-4088
Phone (760) 228-2935

Other providers in Yucca Valley, CA

Barton M Pedersen O.D. an Optometric Corporation
Sara E Bartz
Shantrinia Martriece Basit, LCSW
Itzia Adilene Basulto Montes
Quincy Jean Bates, CPM, LM
Mariah Batin, LMFT
Leevan Reyes Bauer
Bruce Baughman
Kristen Emma Beamer
Salvatore J. Bearse

All providers in Yucca Valley, CA · Physician Assistant in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2017. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.