Individual provider Active NPI

Alicia Anne Gill, PA-C

  • Medical Physician Assistant
  • San Diego, CA
National Provider Identifier
1114690781
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
65607 Issued in CA
Practice address
16647 Crescent Creek Dr
San Diego, CA 92127-7059
Phone
(858) 722-0213
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085008768 IL
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 65607 CA Primary

Addresses

Primary practice location

16647 Crescent Creek Dr
San Diego, CA 92127-7059

Mailing address

16647 Crescent Creek Dr
San Diego, CA 92127-7059
Phone (858) 722-0213

Other practice location 1

4725 Market St
San Diego, CA 92102-4715
Phone (619) 515-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220321001532 IL Practitioner - Physician Assistant 4880089317 Reassigns benefits to 1 organization
I20250415000799 CA Practitioner - Physician Assistant 4880089317 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65607CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Apr 14, 2025 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Apr 14, 2025 Accepting new patients
Access Community Health Network CurrentSince May 9, 2022 Accepting new patients
Access Community Health Network CurrentSince May 9, 2022 Accepting new patients
Access Community Health Network Past Accepting new patients

Locations

4725 Market St
San Diego, CA 92102
Phone (619) 515-2560

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

3700 W 26th St
Chicago, IL 60623
Phone (773) 542-5203

Organizations & group practices 8

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1114690781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16647 CRESCENT CREEK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921277059",
            "telephone_number": "858-722-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16647 CRESCENT CREEK DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921277059",
            "telephone_number": "858-722-0213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4725 Market St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024715",
            "country_code": "US",
            "telephone_number": "619-515-2560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "ALICIA",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085008768",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "65607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.