MR. J. DEXTER R TANJUAKIO P.A.
NPI 1730362229
Physician Assistant in Colton, CA

Q: What is J. Dexter Tanjuakio's NPI number?

The NPI number for J. Dexter Tanjuakio is 1730362229. It was assigned to this individual provider in the NPPES registry on December 7, 2007.

Q: What is J. Dexter Tanjuakio's specialty?

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

Active since December 07, 2007PECOS EnrolledAccepts Medicare Assignment

400 N PEPPER AVE, COLTON, CA 92324(909) 702-8886 Get Directions Write a Review

NPPES record last updated: November 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. J. Dexter R Tanjuakio P.a. NPPES

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

MR. J. DEXTER R TANJUAKIO P.A. (NPI 1730362229) is an individual physician assistant in Colton, California, licensed in California (PA19521) and active in the NPI registry since December 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1730362229

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. J. DEXTER R TANJUAKIOCredential: P.A.

Location Address400 N PEPPER AVEColton, CA 92324-1801

Mailing AddressPo Box 142Upland, CA 91785-0142 · (909) 702-8886

Phone(909) 702-8886

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateDecember 7, 2007

Last NPPES UpdateNovember 18, 2021

NPPES CertifiedNovember 18, 2021

✔ NPI 1730362229 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 · PA19521

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.

400 N PEPPER AVE, Colton, CA 92324

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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 and accepts Medicare assignment

Mr. J. Dexter R Tanjuakio P.a. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375621733

PECOS Enrollment IDI20080424000798

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 92324 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.

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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.

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