Individual provider Active NPI

Chelsea Vilicich, PA-C

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1003408113
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4631 Teller Ave Ste 100
Newport Beach, CA 92660-8105
Phone
(949) 887-7187
NPI assigned
Feb 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4631 Teller Ave Ste 100
Newport Beach, CA 92660-8105

Mailing address

4631 Teller Ave Ste 100
Newport Beach, CA 92660-8105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210712001605 CA Practitioner - Physician Assistant 9931501285 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59169CAMDDentist

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEIIDD/Endpoint/EEIIDD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1003408113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 TELLER AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 TELLER AVE STE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608105",
            "telephone_number": "949-887-7187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILICICH",
        "first_name": "CHELSEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.