Individual provider Active NPI

Corey Crooks, PA-C

  • Physician Assistant
  • Woodlake, CA
National Provider Identifier
1962238097
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
201 E Lakeview Ave
Woodlake, CA 93286-1301
Phone
(844) 767-0540
NPI assigned
Sep 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 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 Primary

Addresses

Primary practice location

201 E Lakeview Ave
Woodlake, CA 93286-1301

Mailing address

PO Box 265
Port Gamble, WA 98364-0265

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
I20260216000875 CA Practitioner - Physician Assistant 0244710648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

305 E Ctr Ave
Visalia, CA 93291-6331

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network CurrentSince Oct 30, 2025 Accepting new patients
Family Healthcare Network CurrentSince Oct 30, 2025 Accepting new patients

Locations

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

201 E Lakeview Ave
Woodlake, CA 93286
Phone (559) 564-0100

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.

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1962238097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "PORT GAMBLE",
            "state": "WA",
            "postal_code": "983640265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LAKEVIEW AVE",
            "city": "WOODLAKE",
            "state": "CA",
            "postal_code": "932861301",
            "telephone_number": "844-767-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOKS",
        "first_name": "COREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodlake, CA

Sources for this page

Verify at the official NPI Registry.