Individual provider Active NPI

Casey Mae Pelletier, PA-C

  • Surgical Physician Assistant
  • Vacaville, CA
National Provider Identifier
1053070144
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA66268 Issued in CA
Practice address
1 Quality Dr
Vacaville, CA 95688-9494
Phone
(707) 624-4000
NPI assigned
Dec 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0011682 DE
Surgical Physician Assistant 363AS0400X PA66268 CA Primary
Physician Assistant 363A00000X C0008278 MD

Addresses

Primary practice location

1 Quality Dr
Vacaville, CA 95688-9494

Mailing address

1 Quality Dr
Vacaville, CA 95688-9494
Phone (707) 624-4000

Other names 1

  • Casey Mae Polasko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220303000344 DE Practitioner - Physician Assistant 9436543758 Reassigns benefits to 1 organization
I20220303001451 MD Practitioner - Physician Assistant 9436543758 Reassigns benefits to 1 organization
I20250826004724 CA Practitioner - Physician Assistant 9436543758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2221 Stockton Blvd
Sacramento, CA 95817-1418
Phone (916) 734-2680

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66268CAMDPharmacist
C5-0011682DEMDPhysician Assistant
C0008278MDMDPhysician Assistant
PA66268CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Feb 1, 2022 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 20, 2025 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 20, 2025 Accepting new patients
Christiana Care Health Services Inc CurrentSince Feb 21, 2022 Accepting new patients
Christiana Care Health Services, Inc Physician Assistant CurrentSince Feb 21, 2022 Accepting new patients
Christiana Care Health Services, Inc Past Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

4735 Ogletown Stanton Rd
Ste 3301
Newark, DE 19713
Phone (302) 623-4370

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

501 W 14th St
#4154
Wilmington, DE 19801
Phone (302) 428-4175

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1053070144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 QUALITY DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956889494",
            "telephone_number": "707-624-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 QUALITY DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956889494",
            "telephone_number": "707-624-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "CASEY",
        "middle_name": "MAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011682",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA66268",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "POLASKO",
            "middle_name": "MAE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.