Individual provider Active NPI

Llesenia Mora, P.A.

  • Medical Physician Assistant
  • Hemet, CA
National Provider Identifier
1194198507
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
53092 Issued in CA
Practice address
949 Calhoun PL
D
Hemet, CA 92543-4403
Phone
(951) 652-8000
NPI assigned
Nov 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 53092 CA Primary

Addresses

Primary practice location

949 Calhoun PL
D
Hemet, CA 92543-4403

Mailing address

949 Calhoun PL
D
Hemet, CA 92543-4403
Phone (951) 652-8000

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
I20160209002909 CA Practitioner - Physician Assistant 7810291952 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Faculty Medical Group IncGroup PAC ID 9436253515, 76 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 656-1500

Merit-based Incentive Payment System (MIPS)

Final score
99.3 of 100Reported as group
Quality
86.71
Improvement activities
40
Cost
82.05

Merit-based Incentive Payment System (MIPS)

Final score
97.34 of 100Reported as group
Quality
84.11
Promoting interoperability
96
Improvement activities
40
Cost
77.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53092CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Feb 1, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Feb 1, 2018 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Interoperability endpoints

  • Direct secure messaging: lmora141816@direct.llu.edu

Organizations & group practices 5

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": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1194198507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 CALHOUN PL",
            "address_2": "D",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434403",
            "telephone_number": "951-652-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 CALHOUN PL",
            "address_2": "D",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925434403",
            "telephone_number": "951-652-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "LLESENIA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "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": "53092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.