Individual provider Active NPI

Anna Davila, PA

  • Surgical Physician Assistant
  • Modesto, CA
National Provider Identifier
1205079514
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
013253 Issued in NY
Practice address
1001 Sylvan Ave Ste a
Modesto, CA 95350-1699
Phone
(209) 422-6120
NPI assigned
Apr 16, 2009
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 013253 NY Primary

Addresses

Primary practice location

1001 Sylvan Ave Ste a
Modesto, CA 95350-1699

Mailing address

1001 Sylvan Ave Ste a
Modesto, CA 95350-1699
Phone (094) 226-1202

Other practice location 1

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-3526

Other practice location 2

1552 Coffee Rd Ste 200
Modesto, CA 95355-3122
Phone (209) 248-7168

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
I20211220002073 CA Practitioner - Physician Assistant 5496947202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
City University of New York School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1001 Sylvan Ave
Suite a
Modesto, CA 95350-1699
Phone (209) 248-7168

644 E Harding Way
Suite B
Stockton, CA 95204-6103
Phone (209) 244-9191

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
013253NYMDChiropractor

Interoperability endpoints

  • Direct secure messaging: adavila603222@hisp.ehr.sutterhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1205079514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SYLVAN AVE STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501699",
            "telephone_number": "094-226-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SYLVAN AVE STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953501699",
            "telephone_number": "209-422-6120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Lenox Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100371802",
            "country_code": "US",
            "telephone_number": "212-939-3526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1552 Coffee Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953553122",
            "country_code": "US",
            "telephone_number": "209-248-7168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "ANNA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "013253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.