EHSAN EJAZ (PA) – Medical Physician Assistant, NPI 1689087892
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,564 PHYSICIAN ASSISTANT in CA
Provider Addresses for EHSAN EJAZ (PA)
3400 DATA DR
ATTN: CREDENTIALING/PAYER ENROLLMENT
RANCHO CORDOVA, CA 956707956
Phone:
Type: Mailing
130 LA CASA VIA STE 3-111
WALNUT CREEK, CA 945983045
Phone: (925) 309-5155
Fax: (925) 623-5156
Type: Location
130 LA CASA VIA STE 210
WALNUT CREEK, CA 945983035
Phone:
Type: Mailing
130 LA CASA VIA # 2-210
WALNUT CREEK, CA 945983045
Phone: (925) 309-5155
Fax: (925) 623-5156
Type: Location
4860 Y ST STE 3740
SACRAMENTO, CA 958172307
Phone: (916) 734-6512
Fax: (916) 703-5368
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $28.
Total Amount is formed as General ($28) + Research ($0) + Ownership ($0) = $28.
Last reported payment date: 2023-03-17 • Largest payer in this snapshot: Vertos Medical, Inc. ($28).
Total Amount
$28
General + Research + Ownership
Payments
1
Total payment records
General Amount
$28
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Vertos Medical, Inc. | $28 |
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: 2019-06-20
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 |
|---|---|---|---|---|
| I20190620001207 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 93 | 93 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 60 | 42 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 57 | 50 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 95670)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NY | |
| - | PA | |
| - | CA | |
| Certified Registered Nurse Anesthetist (Crna) | CA | |
| Physician Assistant | IL | |
| Internal Medicine, Hospice/Palliative Care | CA | |
| Family Practice | CA | |
| - | CA | |
| - | CA | |
| - | CA |
Reviews
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