Individual provider Active NPI

Gabriel Manuel Boyd, PA

  • Surgical Physician Assistant
  • Fresno, CA
National Provider Identifier
1922035989
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA18487 Issued in CA
Practice address
1630 E Herndon Ave
Fresno, CA 93720-3305
Phone
(559) 256-5200
Fax
(559) 256-5376
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X INTERIM LICENSE CA
Surgical Physician Assistant 363AS0400X PA18487 CA Primary

Addresses

Primary practice location

1630 E Herndon Ave
Fresno, CA 93720-3305

Mailing address

2100 Powell St Ste 900
Emeryville, CA 94608-1844
Phone (510) 350-2600

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
I20060823000347 CA Practitioner - Physician Assistant 4284637760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18487CAMDMental Health Counselor
INTERIM LICENSECAMDSurgical Physician Assistant
PA18487CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaweah Delta Health Care District CurrentSince Jan 1, 2010 Accepting new patients
Cep America-California CurrentSince Jan 1, 2010 Accepting new patients

Locations

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

Interoperability endpoints

  • Direct secure messaging: gabriel.boyd.p1@direct.spocortho.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1922035989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203305",
            "telephone_number": "559-256-5200",
            "fax_number": "559-256-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "GABRIEL",
        "middle_name": "MANUEL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "INTERIM LICENSE",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA18487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.