Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Ray S. Kusumoto, PA

Individual provider Medical Physician Assistant · NPI 1194850800

Mr. Ray S. Kusumoto, PA is a Physician Assistant in Hollister, California. Qualified in 1996, 30 years ago. Practices with Bass Medical Group, a 292-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
30
Licensed in
CA
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

591 McCray St Ste 231
Hollister, CA 95023-2224
Phone: (831) 636-3116
Fax: (831) 636-1204
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 890 Sunset Dr, Hollister, CA 95023-5651 — (831) 636-3116

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA13954 (CA)

Record details

NPI number1194850800
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 22, 2007
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Bass Medical Group — 292 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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