Individual provider Active NPI

Maria Alejandra Caicedo, PA

  • Physician Assistant
  • San Jose, CA
National Provider Identifier
1659030732
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
62262 Issued in CA
Practice address
2425 Samaritan Dr
San Jose, CA 95124-3997
Phone
(408) 559-2011
NPI assigned
Dec 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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
Physician Assistant 363A00000X 62262 CA Primary

Addresses

Primary practice location

2425 Samaritan Dr
San Jose, CA 95124-3997

Mailing address

814 California St Apt 4
San Francisco, CA 94108-2329
Phone (954) 651-8165

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
I20230223001369 CA Practitioner - Physician Assistant 7517353816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Virginia Tech Carilion School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 925-7000

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62262CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Feb 22, 2023 Accepting new patients
Cep America-California CurrentSince Feb 22, 2023 Accepting new patients
Cep America - California Current Accepting new patients
Cep America-California CurrentSince Feb 22, 2023 Accepting new patients

Locations

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

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

2425 Samaritan Dr
San Jose, CA 95124
Phone (408) 354-2114

Interoperability endpoints

  • Direct secure messaging: mcaicedo145647@direct.carilionclinic.org
  • Direct secure messaging: mcaicedo454518@direct-ucsfmedicalcenter.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1659030732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 CALIFORNIA ST APT 4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941082329",
            "telephone_number": "954-651-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243997",
            "telephone_number": "408-559-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAICEDO",
        "first_name": "MARIA",
        "middle_name": "ALEJANDRA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.