Individual provider Active NPI

Theresa Sivers-Teixeira, PA-C

  • Medical Physician Assistant
  • Pasadena, CA
National Provider Identifier
1235551995
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA23192 Issued in CA
Practice address
625 South Fair Oaks, #400
Pasadena, CA 91105
Phone
(626) 568-1622
Fax
(626) 865-9560
NPI assigned
Jan 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 23192 CA
Medical Physician Assistant 363AM0700X PA23192 CA Primary

Addresses

Primary practice location

625 South Fair Oaks, #400
Pasadena, CA 91105

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-5900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address theresa.sivers-teixeira@direct.usc.edu Direct

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
I20140728001520 CA Practitioner - Physician Assistant 5193941151 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA23192CAMDMedical Physician Assistant
23192CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince May 7, 2014 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2016 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2016 Accepting new patients
County of Los Angeles CurrentSince May 7, 2014 Accepting new patients

Locations

1000 S Fremont Ave
Unit 22
Alhambra, CA 91803
Phone (213) 364-9847

7601 Imperial Hwy
Downey, CA 90242
Phone (310) 940-8111

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

625 S Fair Oaks Ave
Ste 400
Pasadena, CA 91105
Phone (626) 568-1622

Organizations & group practices 6

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": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1235551995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SOUTH FAIR OAKS, #400",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91105",
            "telephone_number": "626-568-1622",
            "fax_number": "626-865-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVERS-TEIXEIRA",
        "first_name": "THERESA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "23192",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA23192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theresa.sivers-teixeira@direct.usc.edu",
            "affiliation": "Y",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "625 south Fair Oaks, #400",
            "city": "Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "91105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.