Individual provider Active NPI

Tiffany M Varchetto

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1558515593
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
21939 Issued in CA
Practice address
1860 S Sepulveda Blvd
Los Angeles, CA 90025-4314
Phone
(310) 473-5800
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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 21939 CA Primary
Physician Assistant 363A00000X 085003293 IL

Addresses

Primary practice location

1860 S Sepulveda Blvd
Los Angeles, CA 90025-4314

Mailing address

1860 S Sepulveda Blvd
Los Angeles, CA 90025-4314
Phone (949) 430-0789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4622AZMDOccupational Therapy Assistant
21939CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Hills Rejuvenation Medical Associates, Inc. PastSince Jan 24, 2021 Accepting new patients
Homebound Physicians LLC Past Accepting new patients
Physician on Call Past Accepting new patients
Loren S Schechter MD SC LTD Past Accepting new patients
Beverly Hills Rejuvenation Center PastSince May 20, 2018 Accepting new patients
La Health & Wellness Medical Group Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1558515593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254314",
            "telephone_number": "949-430-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 S SEPULVEDA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254314",
            "telephone_number": "310-473-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARCHETTO",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21939",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.