Alicia Marie Muccigrosso, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

21789 Issued in CA

Practice address

6330 San Vicente Blvd
Suite 310
Los Angeles, CA 90048-5425

Phone

(310) 855-0751

NPI assigned

Jul 25, 2010

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

M Ganjianpour, M.D. a Professional CorporationGroup PAC ID 3577769058, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• M Ganjianpour, M.D. a Professional Corporation

  • Specialist
  • Los Angeles, CA
  • NPI 1770806184
  Medicare reassignment Care Compare group
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  NPD (past)

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

{
    "created_epoch": "1280016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1538472162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 SAN VICENTE BLVD",
            "address_2": "SUITE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485425",
            "telephone_number": "310-855-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 SAN VICENTE BLVD",
            "address_2": "SUITE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485425",
            "telephone_number": "310-855-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCCIGROSSO",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-25",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21789",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014104-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mt. Sinai Guest Home
• Mt. Zion Care Speciale, LLC
• Mthfr Doctors LLC
• Henileta Mubako
• Chanel Christine Mucci, MA, LMFT
• David Muchnik
• Gloria Elizabeth Mucino, LCSW
• Kristin Muckley, LCSW
• Laila I Muderspach, M.D.
• Abbie Muecke

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, 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 20, 2013; 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.