Individual provider Active NPI

Ali Williams, PA-C

  • Physician Assistant
  • Hemet, CA
National Provider Identifier
1902182090
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
650 N State St
Hemet, CA 92543-2960
Phone
(951) 791-3300
NPI assigned
Nov 2, 2011
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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 NU Primary

Addresses

Primary practice location

650 N State St
Hemet, CA 92543-2960

Mailing address

218 E Commonwealth Ave
Fullerton, CA 92832-1911
Phone (714) 992-4770

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
I20130626000669 CA Practitioner - Physician Assistant 3476792292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

1330 W Ramsey
Suite 100
Banning, CA 92220
Phone (951) 849-7142

650 N State St
Hemet, CA 92543-2960
Phone (951) 791-3300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21657CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Apr 28, 2013 Accepting new patients
County of Riverside CurrentSince Apr 28, 2013 Accepting new patients

Locations

1330 W Ramsey St
Ste 100
Banning, CA 92220
Phone (951) 849-7142

650 N State St
Hemet, CA 92543
Phone (951) 791-3300

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1902182090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321911",
            "telephone_number": "714-992-4770",
            "fax_number": "714-992-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925432960",
            "telephone_number": "951-791-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ALI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-02",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.