Individual provider Active NPI

Rachel Zdero

  • Physician Assistant
  • Carson, CA
National Provider Identifier
1376297291
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63255 Issued in CA
Practice address
522 W Carson St
Carson, CA 90745-2635
Phone
(310) 320-3400
NPI assigned
Feb 9, 2022
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 63255 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

522 W Carson St
Carson, CA 90745-2635

Mailing address

522 W Carson St
Carson, CA 90745-2635
Phone (310) 320-3400

Other practice location 1

2421 Pacific Coast Hwy
Lomita, CA 90717-2301
Phone (310) 320-3400

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
I20250317001698 CA Practitioner - Physician Assistant 7113449448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Decker DO, Inc.Group PAC ID 9830481746, 23 clinicians

Practice addresses (Care Compare)

2725 E Broadway
Long Beach, CA 90803-5431
Phone (949) 371-9773

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Urgent Care and Wellness Center, Inc. CurrentSince Nov 5, 2023 Accepting new patients

Locations

522 W Carson St
Carson, CA 90745
Phone (310) 320-3400

2421 Pacific Coast Hwy
Lomita, CA 90717
Phone (310) 320-3400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1376297291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W CARSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452635",
            "telephone_number": "310-320-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 W CARSON ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452635",
            "telephone_number": "310-320-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2421 Pacific Coast Hwy",
            "address_purpose": "LOCATION",
            "city": "Lomita",
            "state": "CA",
            "postal_code": "907172301",
            "country_code": "US",
            "telephone_number": "310-320-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZDERO",
        "first_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-09",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63255",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.