Individual provider Active NPI

Allysha Varughese, PA-C

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1316430754
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55644 Issued in CA
Practice address
1140 W la Veta Ave Ste 430
Orange, CA 92868-4226
Phone
(714) 543-5555
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA55644 CA Primary

Addresses

Primary practice location

1140 W la Veta Ave Ste 430
Orange, CA 92868-4226

Mailing address

1712 W Medical Center Dr
Anaheim, CA 92801-1801
Phone (714) 991-5700

Other practice location 1

1401 W 1st St Ste 101
Santa Ana, CA 92703-3757
Phone (714) 542-9700

Other practice location 2

1 Hope Dr
Tustin, CA 92782-0221
Phone (714) 247-0300

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE)

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
I20181109002576 CA Practitioner - Physician Assistant 7911251939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

12100 Euclid St
Garden Grove, CA 92840-3304
Phone (888) 988-2800

23781 Maquina
Mission Viejo, CA 92691-2716
Phone (888) 988-2800

3401 S Harbor Blvd
Santa Ana, CA 92704-7933
Phone (888) 988-2800

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA55644CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 25, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jul 25, 2025 Accepting new patients
Advance Urgent Medical Group Inc PastSince Jun 1, 2016 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

Organizations & group practices 5

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1316430754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 W MEDICAL CENTER DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011801",
            "telephone_number": "714-991-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE STE 430",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684226",
            "telephone_number": "714-543-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 W 1st St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927033757",
            "country_code": "US",
            "telephone_number": "714-542-9700",
            "fax_number": "714-542-9708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927820221",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARUGHESE",
        "first_name": "ALLYSHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1 Hope Dr",
            "city": "Tustin",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927820221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.