Individual provider Active NPI

Elvia Lily Cadena, PA

  • Interventional Pain Medicine Physician
  • Campbell, CA
National Provider Identifier
1568949816
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
55654 Issued in CA
Practice address
3425 S Bascom Ave Ste 200
Campbell, CA 95008-7300
Phone
(408) 356-5295
Fax
(408) 356-5307
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55654 CA
Interventional Pain Medicine Physician 208VP0014X 55654 CA Primary

Addresses

Primary practice location

3425 S Bascom Ave Ste 200
Campbell, CA 95008-7300

Mailing address

3425 S Bascom Ave Ste 200
Campbell, CA 95008-7300
Phone (408) 356-5295

Other names 1

  • Elvia Lily Castro Corea Former name

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
I20181017003741 CA Practitioner - Physician Assistant 6204188360 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55654CAMDPharmacist

Organizations & group practices 2

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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1568949816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 S BASCOM AVE STE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087300",
            "telephone_number": "408-356-5295",
            "fax_number": "408-356-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 S BASCOM AVE STE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087300",
            "telephone_number": "408-356-5295",
            "fax_number": "408-356-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADENA",
        "first_name": "ELVIA",
        "middle_name": "LILY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "55654",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "55654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELVIA",
            "last_name": "CASTRO COREA",
            "middle_name": "LILY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Campbell, CA

Sources for this page

Verify at the official NPI Registry.