Bonnie Schultz Huckaby, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04247 Issued in TX

Practice address

1971 E 4TH St Ste 200
Santa Ana, CA 92705-3917

Phone

(888) 959-5192

NPI assigned

Jul 28, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bhuckaby362573@direct.texashealth.org

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.

• QHP a Professional Corporation

  • Health Service Clinic/Center
  • Santa Ana, CA
  • NPI 1053187187
  Medicare reassignment
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment
• Texas Health Physicians Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1932109204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 LAKE BREEZE CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76132",
            "telephone_number": "817-707-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 E 4TH ST STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053917",
            "telephone_number": "888-959-5192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 Bryant Irvin Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761324026",
            "country_code": "US",
            "telephone_number": "817-263-2500",
            "fax_number": "817-346-4006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUCKABY",
        "first_name": "BONNIE",
        "middle_name": "SCHULTZ",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2022-09-29",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328451501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhuckaby362573@Direct.TexasHealth.org",
            "affiliation": "N",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5701 Bryant Irvin Rd Ste 201",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761324026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Hubbard
• Lisa Hubbell
• Katherine Ann Huber, PHD
• Laura E Hubley, BEHAVIOR TECHNICIAN
• Huckaby Chiropractic, Corp
• Jenny M Hudson, LCSW
• Rosa Angela Huerta Sandoval
• Cindy Laura Huerta
• Danniel Huerta, RN
• Esmeralda Huerta

• Physician Assistant in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.