Mary Jane Maun-Viduya, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19777 Issued in CA

Practice address

655 S Central Valley Hwy
Shafter, CA 93263-2790

Phone

(661) 746-9194

Fax

(661) 746-9197

NPI assigned

Jun 20, 2008

Last updated

Dec 22, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vanguard Medical CorporationGroup PAC ID 4587881685, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vanguard Medical Corporation

  dba Shafter Rural Healthcare Clinic

  • Rural Health Clinic/Center
  • Shafter, CA
  • NPI 1609281310
  Medicare reassignment Care Compare group
• Vanguard Medical Corporation

  • Rural Health Clinic/Center
  • Wasco, CA
  • NPI 1164270807
  NPD
• Vanguard Medical Corporation

  • Primary Care Clinic/Center
  • Bakersfield, CA
  • NPI 1932749108
  NPD
• Bakersfield Memorial Hospital

  dba Bakersfield Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Bakersfield, CA
  • NPI 1144256363
  NPD (past)
• Central California Emergency Medicine Physicians

  • Emergency Medicine Physician
  • Bakersfield, CA
  • NPI 1265546451
  NPD (past)
• Jae J. Kim, M.D.

  dba Shafter Rural Health Care Clinic

  • Primary Care Clinic/Center
  • Shafter, CA
  • NPI 1073796843
  NPD (past)
• Omni Family Health

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1770399669
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1962663005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 S CENTRAL VALLEY HWY",
            "address_2": "P.O. BOX 1060",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632790",
            "telephone_number": "661-459-1900",
            "fax_number": "661-459-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S CENTRAL VALLEY HWY",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932632790",
            "telephone_number": "661-746-9194",
            "fax_number": "661-746-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUN-VIDUYA",
        "first_name": "MARY",
        "middle_name": "JANE",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirka Lopez
• Zachary Michael Luce, DPT
• Jelita Macanas
• Isis Samanta Macias Moreno, M.D
• Maple Elementary School District
• Avery McManus, RD
• Debra Ann Metter, DO
• Michael Komin MD Medical Corportion
• Brittany Millwee
• Julia Montoya

• Physician Assistant in Shafter, CA
• Providers in Shafter, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.