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AARON DEATHERAGE
NPI 1003563875
Student in an Organized Health Care Education/Training Program in Corona, CA

Active since March 02, 2022PECOS Enrolled
800 S MAIN ST, CORONA, CA 92882(951) 737-4343 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 11, 2026, Mar 2, 2022 (2 updates tracked since 2022).

About Aaron Deatherage NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AARON DEATHERAGE (NPI 1003563875) is an individual student in an organized health care education/training program in Corona, California and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003563875
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameAARON DEATHERAGE
Location Address800 S MAIN STCorona, CA 92882-3420
Mailing Address800 S Main StCorona, CA 92882-3420 · (951) 737-4343
Phone(951) 737-4343
Sole ProprietorNo
Enumeration DateMarch 2, 2022
Last NPPES UpdateMarch 11, 20262 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1003563875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 20A23276 (CA)
800 S MAIN ST, Corona, CA 92882
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Aaron Deatherage is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CRYSTAL SOULE
Dietitian, Registered
800 S MAIN ST
CORONA, CA 92882
Riverside County (951) 737-4343
CHERYL JANE SAPIDA P.A
Physician Assistant
800 S MAIN ST
CORONA, CA 92882
Riverside County (909) 736-6241
INTEGRATED ANESTHESIA MEDICAL GROUP PC
Anesthesiology (Pain Medicine)
800 S MAIN ST
CORONA, CA 92882
Riverside County (310) 379-2134
JEFFREY RIEKER M.D.
Anesthesiology
800 S MAIN ST
CORONA, CA 92882
Riverside County (951) 737-4343
SCOTT MATTHEW BROWN P.A.-C
Physician Assistant
800 S MAIN ST
CORONA, CA 92882
Riverside County (909) 736-6241
DHIREN PATEL FNP-C
Nurse Practitioner (Family)
800 S MAIN ST
CORONA, CA 92882
Riverside County (951) 737-4343
WENDY S MARTIN MD
Anesthesiology
800 S MAIN ST
CORONA, CA 92882
Riverside County (909) 737-4343
PROVIDENT HOSPITALIST ASSOCIATES, A PROFESSIONAL MEDICAL CORPORATION
Internal Medicine
800 S MAIN ST
CORONA, CA 92882
Riverside County (951) 737-4343

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Aaron Deatherage's NPI number?

The NPI number for Aaron Deatherage is 1003563875. It was assigned to this individual provider in the NPPES registry on March 2, 2022.

Where is Aaron Deatherage located?

Aaron Deatherage practices at 800 S Main St, Corona, CA 92882. The listed phone number is (951) 737-4343.

What is Aaron Deatherage's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Aaron Deatherage enrolled in Medicare?

Yes. Aaron Deatherage is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Aaron Deatherage was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.