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MICKOYAN NAKITA POOLE PA-C
NPI 1316201734
Physician Assistant in Rialto, CA

Active since June 29, 2012PECOS Enrolled
425 E FOOTHILL BLVD, RIALTO, CA 92376(909) 546-1005(909) 546-1061 Get Directions Write a Review

NPPES record last updated: February 7, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mickoyan Nakita Poole Pa-c NPPES

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

MICKOYAN NAKITA POOLE PA-C (NPI 1316201734) is an individual physician assistant in Rialto, California, licensed in California (15766) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316201734
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMICKOYAN NAKITA POOLECredential: PA-C
Location Address425 E FOOTHILL BLVDRialto, CA 92376-5153
Mailing Address425 E Foothill BlvdRialto, CA 92376-5153 · (909) 546-1050
Phone(909) 546-1005
Fax(909) 546-1061
Sole ProprietorYes
Enumeration DateJune 29, 2012
Last NPPES UpdateFebruary 7, 2022
NPPES CertifiedFebruary 7, 2022
✔ NPI 1316201734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 15766
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
425 E FOOTHILL BLVD, Rialto, CA 92376
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Other Identifiers 1

Medicaid1316201734CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mickoyan Nakita Poole Pa-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92376 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

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

ISAIS WELLINGTON SMITH
Counselor (Mental Health)
425 E FOOTHILL BLVD
RIALTO, CA 92376
San Bernardino County (909) 546-1050
AMANDA VO NP
Nurse Practitioner (Obstetrics & Gynecology)
425 E FOOTHILL BLVD
RIALTO, CA 92376
San Bernardino County (909) 546-1050
SAN MARCOS MEDICAL GROUP, INC.
Obstetrics & Gynecology
425 E FOOTHILL BLVD
RIALTO, CA 92376
San Bernardino County (909) 546-1050
KATHERINE BRAVO
Community Health Worker
425 E FOOTHILL BLVD
RIALTO, CA 92376
San Bernardino County (909) 546-1050
ANGIE SANCHEZ
Community Health Worker
425 E FOOTHILL BLVD
RIALTO, CA 92376
San Bernardino County (909) 546-1050
EMMANUEL OBIAJULU UNACHUKWU M.D
Pediatrics
425 E FOOTHILL BLVD
RIALTO, CA 92376
San Bernardino County (909) 546-1050
CENTRAL NEIGHBORHOOD HEALTH FOUNDATION - RIALTO
Clinic/Center (Community Health)
425 E FOOTHILL BLVD
RIALTO, CA 92376
San Bernardino County (909) 546-1052

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 Mickoyan Poole's NPI number?

The NPI number for Mickoyan Poole is 1316201734. It was assigned to this individual provider in the NPPES registry on June 29, 2012.

Where is Mickoyan Poole located?

Mickoyan Poole practices at 425 E Foothill Blvd, Rialto, CA 92376. The listed phone number is (909) 546-1005.

What is Mickoyan Poole's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mickoyan Poole enrolled in Medicare?

Yes. Mickoyan Poole is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mickoyan Poole was last updated on February 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.