Individual provider Active NPI

Lydia Pereverzina, PA

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1326848904
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA67257 Issued in CA
Practice address
317 26TH St
Sacramento, CA 95816-3108
Phone
(971) 344-0833
NPI assigned
Mar 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 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 PA67257 CA Primary

Addresses

Primary practice location

317 26TH St
Sacramento, CA 95816-3108

Mailing address

2570 48TH St
Sacramento, CA 95817-1541
Phone (916) 734-5625

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
I20260212004199 CA Practitioner - Physician Assistant 3678053337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Assistant Surgical Assist IncGroup PAC ID 8123271749, 35 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 781-1552

1650 Creekside Dr
Folsom, CA 95630-3400
Phone (916) 983-7400

1651 Creekside Dr
Suite 100
Folsom, CA 95630-3833
Phone (916) 673-1990

4001 J St
Sacramento, CA 95819-3626
Phone (916) 453-4545

6501 Coyle Ave
Carmichael, CA 95608-0306
Phone (916) 537-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA67257CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Assistant Surgical Assist, Inc CurrentSince Dec 16, 2025 Accepting new patients

Locations

1651 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (702) 458-2304

6520 Lonetree Blvd
Ste 2009
Rocklin, CA 95765
Phone (702) 458-2304

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1326848904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 48TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171541",
            "telephone_number": "916-734-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 26TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958163108",
            "telephone_number": "971-344-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREVERZINA",
        "first_name": "LYDIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.