Exagen Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 00334804 Issued in CA

Legal business name

EXAGEN INC.

Practice address

1261 Liberty Way Ste C
Vista, CA 92081-8356

Phone

(888) 452-1522

Fax

(760) 479-6486

NPI assigned

Jul 15, 2008

Organization subpart

No

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

Authorized official

Name

Nikki Killings

Title

Director of Operations

Phone

(760) 539-3031

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Exagen Diagnostics Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prashanti Reddy, M.D.

  • Specialist
  • Sacramento, CA
  • NPI 1285759738
  NPD
• Thierry Dervieux, PHD DABCC

  • Medical Laboratory Technician
  • Vista, CA
  • NPI 1649622051
  NPD (past)

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1245494517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27561",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871257561",
            "telephone_number": "888-452-1522",
            "fax_number": "760-479-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 LIBERTY WAY STE C",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920818356",
            "telephone_number": "888-452-1522",
            "fax_number": "760-479-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXAGEN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "KILLINGS",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "760-539-3031"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 00334804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE DEPARTMENT OF HEALTH",
            "identifier": "8369",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ555113Y",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND DEPT OF HEALTH",
            "identifier": "1484",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHODE ISLAND DEPT OF HEALTH",
            "identifier": "LCO00685",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA DEPT OF HEALTH",
            "identifier": "31066",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1075048",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL AND PUBLIC HEALTH LABORATORY LICENSE",
            "identifier": "CDF-00334804",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Exagen Diagnostics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• David Gary Evans, M.D.
• Edward Barton Evans, M.D.
• Becky Evanson, MSW
• Elizabeth Maureen Everett, APRN-C
• Erika Everson
• Exodus Recovery, Inc.
• Exodus Recovery, Inc.
• Exodus Recovery, Inc.
• Exodus Recovery, Inc.
• Exodus Recovery, Inc.

• Clinical Medical Laboratory in Vista, CA
• Providers in Vista, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.