Carissa Leigh Villavicencio, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

655 W Avenue Q
Palmdale, CA 93551-3894

Phone

(661) 259-5200

NPI assigned

Aug 29, 2018

Sex

Female

Sole proprietor

No

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 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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Exer Medical Corporation

  • Urgent Care Clinic/Center
  • Calabasas, CA
  • NPI 1588901532
  Medicare reassignment Care Compare group
• Providence Facey Medical Foundation

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment NPD
• Providence Facey Medical Foundation

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1891348447
  NPD

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1205318938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27898 SKYCREST CIR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913541415",
            "telephone_number": "661-904-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W AVENUE Q",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513894",
            "telephone_number": "661-259-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "CARISSA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jannah Mariel Villaflor, BSN, RN
• Maria Lidia Villafranco
• Melannie Villafranco
• Ian Talusan Villanueva
• Jessica Marie Villarreal
• Purificacion Paguyo Villegas, RN
• Frances Vine, PSY.D.
• Vinod Kannarkat MD Inc., Cardiac Rhythm Institute
• Vintage Medical Group of Palmdale
• Ruben Virgen

• Physician Assistant in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.