Individual provider Active NPI

Vincent Lieras, PA

  • Physician Assistant
  • Lake Elsinore, CA
National Provider Identifier
1477074094
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA54581 Issued in CA
Practice address
31581 Canyon Estates Dr
Lake Elsinore, CA 92532-0424
Phone
(951) 244-3500
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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 PA54581 CA Primary
Family Medicine Physician 207Q00000X PA54581 CA

Addresses

Primary practice location

31581 Canyon Estates Dr
Lake Elsinore, CA 92532-0424

Mailing address

30300 Antelope Rd Apt 1826
Menifee, CA 92584-9568
Phone (619) 203-4536

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
I20170928002117 CA Practitioner - Physician Assistant 1759655848 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA54581CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of California, a Medical Corporation CurrentSince Dec 1, 2025 Accepting new patients
American Current Care of California, a Medical Corporation CurrentSince Dec 1, 2025 Accepting new patients
Carbon Health Medical Group of California PC CurrentSince Jan 7, 2023 Accepting new patients
Cep America - California CurrentSince Aug 4, 2017 Accepting new patients

Locations

1800 Westwind Dr
Ste 301
Bakersfield, CA 93301
Phone (661) 327-9617

6971 El Camino Real
Ste 101
Carlsbad, CA 92009
Phone (760) 258-4971

11971 Central Ave
Ste B
Chino, CA 91710
Phone (909) 310-1488

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

3955 Bedford Canyon Rd
Unit 103
Corona, CA 92883
Phone (951) 293-4722

2555 S East Ave
Fresno, CA 93706
Phone (559) 499-2400

14443 Culver Dr
#14443A
Irvine, CA 92604
Phone (949) 767-8173

1340 Mitchell Rd
Modesto, CA 95351
Phone (209) 581-9711

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

25115 Madison Ave
Murrieta, CA 92562
Phone (951) 600-9070

1101 S Milliken Ave
Ste C
Ontario, CA 91761
Phone (909) 390-2799

1851 Lombard St
Ste 100
Oxnard, CA 93030
Phone (805) 983-2234

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

640 S Placentia Ave
Placentia, CA 92870
Phone (714) 579-7772

2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055

2587 Merced St
San Leandro, CA 94577
Phone (510) 351-3553

740 Nordahl Rd
Ste 131
San Marcos, CA 92069
Phone (760) 432-9000

988 Walsh Ave
Santa Clara, CA 95050
Phone (408) 988-6868

1221 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 543-8360

2944 Tapo Canyon Rd
Ste A
Simi Valley, CA 93063
Phone (805) 306-5990

3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500

3663 Arch Rd
Ste 400
Stockton, CA 95215
Phone (209) 943-2202

21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333

3680 Industrial Blvd
Ste 550H
West Sacramento, CA 95691
Phone (916) 373-7575

Interoperability endpoints

  • Direct secure messaging: vincent.lieras.p17@direct.regal.nextgenshare.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1477074094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30300 ANTELOPE RD APT 1826",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925849568",
            "telephone_number": "619-203-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31581 CANYON ESTATES DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320424",
            "telephone_number": "951-244-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIERAS",
        "first_name": "VINCENT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54581",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA54581",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

Verify at the official NPI Registry.