{
  "npi": "1972744399",
  "enumeration_type": "NPI-1",
  "basic": {
    "certification_date": "2022-05-19",
    "credential": "PA-C",
    "enumeration_date": "2009-03-14",
    "first_name": "FERNANDO",
    "last_name": "ACOSTA",
    "last_updated": "2022-05-19",
    "name_prefix": "Mr.",
    "sex": "M",
    "sole_proprietor": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "245 TERRACINA BLVD STE 202",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "REDLANDS",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "923734867",
      "state": "CA",
      "telephone_number": "909-793-3311"
    },
    {
      "address_1": "PO BOX 10069",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SAN BERNARDINO",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "924230069",
      "state": "CA",
      "telephone_number": "909-335-4188"
    }
  ],
  "taxonomies": [
    {
      "code": "363A00000X",
      "desc": "Physician Assistant",
      "license": "PA20237",
      "primary": true,
      "state": "CA",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "97",
        "medicare_type": "Physician Assistant"
      }
    ]
  }
}