Kendra Kay Cavazo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6553 E Pacific Coast Hwy
H9
Long Beach, CA 90803-4202

Phone

(562) 596-8700

NPI assigned

Oct 7, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcavazo782904@direct.memorialcare.org

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group
• Anaheim Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Anaheim, CA
  • NPI 1962680033
  Medicare reassignment NPD
• Anaheim Urgent Care, Inc

  • Urgent Care Clinic/Center
  • Beverly Hills, CA
  • NPI 1619682788
  NPD
• Orange County Urgent Care #3, Inc.

  • Urgent Care Clinic/Center
  • Long Beach, CA
  • NPI 1619445111
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Harbor City, CA
  • NPI 1598797011
  NPD

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

• Long Beach Memorial Medical

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1962442012
  Care Compare affiliation

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1154631257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6553 E PACIFIC COAST HWY",
            "address_2": "H9",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034202",
            "telephone_number": "562-596-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6553 E PACIFIC COAST HWY",
            "address_2": "H9",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034202",
            "telephone_number": "562-596-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVAZO",
        "first_name": "KENDRA",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1095226",
            "state": "CA"
        }
    ],
    "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": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alynn Cauldwell, LMFT
• Alexis Khalisse Causey
• Camille Chanel Cauthen
• Richard Joseph Cavallaro Jr., PHARMD
• Edward Francis Cavanagh, M.D.
• Zachary M Cayaban
• Bertha Margarita Cazarez
• Daisy Ceballos
• Luis Miguel Ceballos
• Rene Ceballos

• Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.