Surgical Physician Assistant Specialist, Inc.
NPI 1619544178ActiveOrganization· Exclusive Provider Organization· La Mesa, CA
Exclusive Provider Organization in La Mesa, California, registered in NPPES in June 2021. The authorized official on file is Zachary Periharos, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1619544178 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 4, 2021 |
| Last updated in NPPES | Jan 22, 2026 |
| Certified by provider | Jan 22, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Exclusive Provider Organization Primary | 302F00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
Other Exclusive Provider Organization providers in La Mesa
- 1306022686
- 1962949057
All Exclusive Provider Organization providers in California →