Individual provider Active NPI

Vincent Martin Caserio, PA-C

  • Physician Assistant
  • Calabasas, CA
National Provider Identifier
1417440603
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA55670 Issued in CA
Practice address
26585 Agoura Rd Ste 320
Calabasas, CA 91302-1958
Phone
(310) 319-3475
NPI assigned
Jun 12, 2018
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X PA5670 CA
Physician Assistant 363A00000X PA55670 CA Primary

Addresses

Primary practice location

26585 Agoura Rd Ste 320
Calabasas, CA 91302-1958

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1414 S Grand Ave Ste 380
Los Angeles, CA 90015
Phone (213) 222-1300

Other practice location 2

11550 Indian Hills Rd Ste 261
Mission Hills, CA 91345-1244
Phone (818) 361-0917

Other identifiers 2

IdentifierTypeStateIssuer
PA55670OtherCASTATE LICENSE
1152011OtherNCCPA

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
I20181011000496 CA Practitioner - Physician Assistant 5395097893 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

26585 Agoura Rd
Calabasas, CA 91302-1958

300 Medical PLZ
Los Angeles, CA 90095-0001
Phone (310) 825-5111

7300 Medical Ctr Dr
West Hills, CA 91307-1902
Phone (818) 676-4000

757 Westwood PLZ
Los Angeles, CA 90095-8358

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA55670CAMDPhysician Assistant
PA5670CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince Apr 19, 2021 Accepting new patients
The Regents of the University of California CurrentSince Dec 1, 2024 Accepting new patients
UCLA Medical Group Past Accepting new patients

Locations

191 S Buena Vista St
Ste 470
Burbank, CA 91505
Phone (818) 848-3030

26585 Agoura Rd
Ste 320
Calabasas, CA 91302
Phone (310) 999-9999

26585 Agoura Rd
Ste 330
Calabasas, CA 91302
Phone (818) 461-3321

15503 Ventura Blvd
Ste 240
Encino, CA 91436
Phone (310) 825-7163

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

File 54206
Los Angeles, CA 90074

11550 Indian Hls
Ste 261
Mission Hills, CA 91345
Phone (818) 361-0917

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: vcaserio1284371@direct.uclahealth.org

Organizations & group practices 6

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 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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1417440603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26585 AGOURA RD STE 320",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021958",
            "telephone_number": "310-319-3475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 S Grand Ave Ste 380",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90015",
            "country_code": "US",
            "telephone_number": "213-222-1300",
            "fax_number": "213-222-1333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11550 Indian Hills Rd Ste 261",
            "address_purpose": "LOCATION",
            "city": "Mission Hills",
            "state": "CA",
            "postal_code": "913451244",
            "country_code": "US",
            "telephone_number": "818-361-0917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASERIO",
        "first_name": "VINCENT",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA5670",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA55670",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1152011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.