James Fuller, PA
Individual provider Active NPI Physician Assistant · Shafter, CA
NPI 1942229281 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1942229281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA18379 (CA)
- Practice address
- 659 S Central Valley Hwy
Shafter, CA 93263-2790 - Phone
- (661) 459-1900
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 92.07
- Improvement activities
- 40
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
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060505000943 | CA | Practitioner - Physician Assistant | 7911918800 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18379 | CA | MD | Acupuncturist |
| PA18379 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kern County Hospital Authority | Current |
Accepting new patients | |
| Cep America-California | Current |
Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current |
Accepting new patients | |
| Omni Family Health | Past | Accepting new patients | |
| Omni Family Health | Past | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18379 | CA | Yes |
Addresses
Primary practice location
659 S Central Valley Hwy
Shafter, CA 93263-2790
Mailing address
928 S Farragut St
Ridgecrest, CA 93555-7508
Phone (760) 375-1330
Other providers in Shafter, CA
- Engage Physical Therapy Inc.
- Amgad A Faragalla
- Haylee Foch
- Joseph Alberto Francisco
- Trude L. Frazer
- Norbert Gal
- Rubie Galoyo
- Alicia E Garcia
- Desiree Garza
- Glinn and Giordano Physical Therapy Inc.
All providers in Shafter, 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 Jul 8, 2007. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.