Individual provider Active NPI

Stefenie Nazanin Casuto

  • Physician Assistant
  • Escondido, CA
National Provider Identifier
1023467065
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53680 Issued in CA
Practice address
1955 Citracado Pkwy Ste 302
Escondido, CA 92029-4113
Phone
(760) 743-5111
NPI assigned
Jun 10, 2016
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53680 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1955 Citracado Pkwy Ste 302
Escondido, CA 92029-4113

Mailing address

PO Box 33865
San Diego, CA 92163-3865
Phone (858) 888-7700

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1023467065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33865",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921633865",
            "telephone_number": "858-888-7700",
            "fax_number": "858-500-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 CITRACADO PKWY STE 302",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294113",
            "telephone_number": "760-743-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASUTO",
        "first_name": "STEFENIE",
        "middle_name": "NAZANIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53680",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.