NPIMap

Individual provider Active NPI

Nicolas Dejong, PA-C

  • Physician Assistant
  • Oxnard, CA
National Provider Identifier
1902204803
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55150 Issued in CA
Practice address
1751 Lombard St Ste a
Oxnard, CA 93030
Phone
(805) 981-9111
NPI assigned
Dec 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physician Assistant 363A00000X PA60604695 WA
Physician Assistant 363A00000X PA55150 CA Primary

Addresses

Primary practice location

1751 Lombard St Ste a
Oxnard, CA 93030

Mailing address

1751 Lombard St Ste a
Oxnard, CA 93030-8266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180322001613 CA Practitioner - Physician Assistant 9234439787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Medical Group of Ventura County IncGroup PAC ID 0345218160, 42 clinicians
Burrows Family Practice IncGroup PAC ID 3678861457, 2 clinicians

Practice addresses (Care Compare)

10885 Telegraph Rd
Ventura, CA 93004-1272
Phone (805) 647-7704

1377 S Grand Ave
Glendora, CA 91740-5047
Phone (626) 483-3348

2772 Johnson Dr
Suite 200
Ventura, CA 93003-7262
Phone (805) 642-1430

3555 Loma Vista Rd
Suite 110
Ventura, CA 93003-3161
Phone (805) 653-0303

888 W Ventura Blvd
Suite a
Camarillo, CA 93010-8803
Phone (805) 383-7701

Hospital & facility affiliations

  • Livingston Memorial Visiting Nurse Association Home health agency, Ventura, CA, CCN 057040
  • Mission Home Health of Ventura, LLC Home health agency, Oxnard, CA, CCN 557219
  • Assisted Home Care Home health agency, Ventura, CA, CCN 058039
  • Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
55150CAMDPharmacist
PA55150CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Burrows Family Practice, Inc. CurrentSince Jan 22, 2026 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nicolas.dejong.1@21226.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1902204803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 LOMBARD ST STE A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930308266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 LOMBARD ST STE A",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "93030",
            "telephone_number": "805-981-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONG",
        "first_name": "NICOLAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-09",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60604695",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.