Stephanie Agoncillo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

53464 Issued in CA

Practice address

2911 Chanticleer Ave
Santa Cruz, CA 95065-1815

Phone

(831) 477-2350

NPI assigned

Aug 28, 2015

Last updated

Nov 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Maternity & Surgery Center of Santa Cruz Hospital, Santa Cruz, CA, CCN 050714
• Dominican Hospital Hospital, Santa Cruz, CA, CCN 050242

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sagoncillo347550@hisp.ehr.sutterhealth.org

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.

• Sutter Bay Medical Foundation

  dba Palo Alto Medial Foundation

  • Multi-Specialty Clinic/Center
  • Palo Alto, CA
  • NPI 1013950807
  Medicare reassignment Care Compare group NPD
• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Clinical Medical Laboratory
  • Santa Clara, CA
  • NPI 1669287033
  NPD
• Planned Parenthood Mar Monte, Inc.

  dba Mar Monte Community Clinic

  • Community Health Clinic/Center
  • San Jose, CA
  • NPI 1598536971
  NPD (past)
• Sutter East Bay Medical Foundation

  • Family Medicine Physician
  • Orinda, CA
  • NPI 1871538769
  NPD (past)
• University of North Carolina at Chapel Hill

  dba UNC Faculty Physicians

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  dba Dominican Hospital

  • General Acute Care Hospital
  • Santa Cruz, CA
  • NPI 1427181007
  Care Compare affiliation
• Sutter Bay Hospitals

  dba Sutter Maternity & Surgery Center of Santa Cruz

  • General Acute Care Hospital
  • Santa Cruz, CA
  • NPI 1689035628
  Care Compare affiliation

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1427425172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 CHANTICLEER AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651815",
            "telephone_number": "831-477-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 CHANTICLEER AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651815",
            "telephone_number": "831-477-2350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Waterstone Dr",
            "address_purpose": "LOCATION",
            "city": "Hillsborough",
            "state": "NC",
            "postal_code": "272789078",
            "country_code": "US",
            "telephone_number": "919-595-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGONCILLO",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Agbuya-Flores, O.D.
• Elizabeth Agee
• Erin Agenjo Hohengarten, LCSW
• Bahar Aghighi, MD
• Lana Agojo
• Julie R Aguiar, MFT
• Kimberly Aguilar-Cortez
• Beatriz Aguilar
• Diane Aguilar
• Sandra Aguilar

• Physician Assistant in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.