Individual provider Active NPI

Valerie Veronica Monge, PA

  • Physician Assistant
  • San Luis Obispo, CA
National Provider Identifier
1356548051
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16443 Issued in CA
Practice address
1 Grand Ave
San Luis Obispo, CA 93407-9000
Phone
(805) 756-1211
Fax
(805) 156-5298
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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 PA16443 CA Primary

Addresses

Primary practice location

1 Grand Ave
San Luis Obispo, CA 93407-9000

Mailing address

1 Grand Ave
San Luis Obispo, CA 93407-9000
Phone (805) 756-1211

Other identifiers 1

IdentifierTypeStateIssuer
PA16433OtherCAPA STATE LICENSE

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
I20241017004478 CA Practitioner - Physician Assistant 1153853973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cottage Clinical Network LLCGroup PAC ID 1850712530, 57 clinicians
Family and Industrial Medical Center IncGroup PAC ID 1759318256, 9 clinicians

Practice addresses (Care Compare)

1846 N Broadway
Suite a
Santa Maria, CA 93454-1447
Phone (805) 361-4279

47 Santa Rosa St
San Luis Obispo, CA 93405-1811
Phone (805) 542-9596

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: valerie.monge.1@13850.direct.athenahealth.com

Organizations & group practices 2

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1356548051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GRAND AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934079000",
            "telephone_number": "805-756-1211",
            "fax_number": "805-156-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GRAND AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934079000",
            "telephone_number": "805-756-1211",
            "fax_number": "805-156-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGE",
        "first_name": "VALERIE",
        "middle_name": "VERONICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE",
            "identifier": "PA16433",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.