NPIMap

Individual provider Active NPI

Christopher J Pilaczynski, PA-C

  • Medical Physician Assistant
  • Fairfield, CA
National Provider Identifier
1396963997
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18727 Issued in CA
Practice address
530 Union Ave
Fairfield, CA 94533-6367
Phone
(707) 421-7151
Fax
(707) 421-6674
NPI assigned
Apr 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA18727 CA Primary

Addresses

Primary practice location

530 Union Ave
Fairfield, CA 94533-6367

Mailing address

397 Oak Valley Dr
Vacaville, CA 95687-7113
Phone (707) 446-2164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080429000748 CA Practitioner - Physician Assistant 5991884108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Glenn Medical Center, IncGroup PAC ID 3870505035, 13 clinicians
Glenn Medical Center, LLCGroup PAC ID 4486050838, 13 clinicians

Practice addresses (Care Compare)

1133 W Sycamore St
Willows, CA 95988-2601
Phone (530) 934-1881

888 Pacific Ave
Willows, CA 95988-2023

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18727CAMDMedical Physician Assistant
18727CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Medical Center, LLC Current Accepting new patients
Glenn Medical Center, LLC CurrentSince Jul 31, 2024 Accepting new patients
Colusa Medical Center, LLC Past Accepting new patients
Glenn Medical Center, LLC Past Accepting new patients

Locations

1133 W Sycamore St
Willows, CA 95988
Phone (530) 934-1800

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396963997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 OAK VALLEY DR",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956877113",
            "telephone_number": "707-446-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 UNION AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336367",
            "telephone_number": "707-421-7151",
            "fax_number": "707-421-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILACZYNSKI",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.