MARK CROSS (PA-C) – Physician Assistant, NPI 1205964939
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for MARK CROSS (PA-C)
874 MAIN ST
FORTUNA, CA 955401926
Phone: (707) 725-3334
Fax: (707) 725-2455
Type: Mailing
2650 E FOOTHILL BLVD
PASADENA, CA 911073439
Phone: (626) 577-2261
Fax: (707) 725-2455
Type: Location
4723 W MAIN ST STE H
GUADALUPE, CA 934341787
Phone: (805) 361-8017
Fax: (805) 361-8097
Type: Location
2050 S BLOSSER RD
SANTA MARIA, CA 934587310
Phone: (805) 361-8017
Fax: (805) 361-8097
Type: Mailing
560 W PUTNAM AVE
PORTERVILLE, CA 932573269
Phone: (559) 781-1665
Fax: (559) 781-6036
Type: Location
PO BOX 3687
COEUR D ALENE, ID 838162529
Phone: (208) 819-2183
Fax: (208) 209-6063
Type: Mailing
2426 N MERRITT CREEK LOOP STE A
COEUR D ALENE, ID 838144961
Phone: (208) 819-2183
Fax: (208) 209-6063
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-11-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081114000107 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 95540)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Nurse Practitioner | CA | |
| Physician Assistant | CA | |
| Nurse Practitioner | CA | |
| Family Practice | CA | |
| Family Practice, Internal Medicine | CA | |
| Physician Assistant | CA | |
| O T O L A R Y N G O L O G Y | CA | |
| Physician Assistant | IL | |
| Nurse Practitioner | OR |
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