Alyssa San Diego, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2310 North Blvd W Ste a
Davenport, FL 33837-8988

Phone

(813) 701-5804

NPI assigned

Dec 18, 2023

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

Medicare fee-for-service enrollment

Enrolled in FL

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Excel Pain and Spine LLCGroup PAC ID 8123447869, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Excel Pain and Spine LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun City Center, FL
  • NPI 1063028587
  Medicare reassignment Care Compare group
• Excel Pain and Spine LLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Sarasota, FL
  • NPI 1023811619
  NPD

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740873600000",
    "number": "1194593376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2672 PATRICIAN CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 NORTH BLVD W STE A",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378988",
            "telephone_number": "813-701-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN DIEGO",
        "first_name": "ALYSSA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2025-03-02",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin Manuel Salamanca, MD
• Magela Salgado Cervantes
• Joseph A Salhab, DO
• Sherline Laine Salmon Salmon, CNA
• Micheline Salomon, MSW
• Julio Raul San Martin, MD
• Ana Hilda Cruz Sanabria
• Ricardo R Sanchez Maceira, M.D.
• Dioleisy Sanchez Suarez
• Jesus David Sanchez

• Physician Assistant in Davenport, FL
• Providers in Davenport, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2025; 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.