Individual provider Active NPI

Ilaria Oliver Mastroserio, PA-C

  • Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1376197590
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
177 La Casa Via Ste 390
Walnut Creek, CA 94598-6101
Phone
(925) 692-5610
NPI assigned
Jul 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 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 Primary

Addresses

Primary practice location

177 La Casa Via Ste 390
Walnut Creek, CA 94598-6101

Mailing address

1450 Treat Blvd Ste 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2828

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
I20231023003598 CA Practitioner - Physician Assistant 0840521779 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

177 La Casa Via
Suite 200E
Walnut Creek, CA 94598-6101
Phone (925) 692-5927

2400 Balfour Rd
Suite 120
Brentwood, CA 94513-4956
Phone (925) 308-8112

2571 Park Ave
Concord, CA 94520-1901
Phone (925) 674-2100

Hospital & facility affiliations

  • John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496
  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

Merit-based Incentive Payment System (MIPS)

Final score
90.32 of 100Reported as group
Quality
89.54
Promoting interoperability
100
Improvement activities
40
Cost
74.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62292CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Sep 9, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 9, 2023 Accepting new patients
John Muir Physician Network CurrentSince Jun 10, 2024 Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

400 Parnassus Ave
Bldg 4TH
San Francisco, CA 94143

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

1450 Treat Blvd
Ste 300
Walnut Creek, CA 94597

1450 Treat Blvd
#300
Walnut Creek, CA 94597
Phone (925) 952-2828

177 La Casa Via
Ste 390
Walnut Creek, CA 94598
Phone (925) 692-5610

Interoperability endpoints

  • Direct secure messaging: imastroserio171920@ehr.johnmuirhealth.com
  • Direct secure messaging: imastroserio63553@direct-ucsfmedicalcenter.org

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.

Hospital & facility affiliations 2

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1376197590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD STE 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 LA CASA VIA STE 390",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945986101",
            "telephone_number": "925-692-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROSERIO",
        "first_name": "ILARIA",
        "middle_name": "OLIVER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.