Individual provider Active NPI

Desiree Ann Pasillas

  • Emergency Medicine Physician
  • Riverside, CA
National Provider Identifier
1669848222
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
PA52968 Issued in CA
Practice address
3257 Pontiac Ave
Riverside, CA 92509-4430
Phone
(951) 345-2142
NPI assigned
Aug 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 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
Emergency Medicine Physician 207P00000X PA52968 CA Primary

Addresses

Primary practice location

3257 Pontiac Ave
Riverside, CA 92509-4430

Mailing address

3257 Pontiac Ave
Riverside, CA 92509-4430
Phone (951) 345-2142

Other names 1

  • Miss Desiree Ann Cwick Other 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
I20151112002215 CA Practitioner - Physician Assistant 6305156878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
PA52968CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

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

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

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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1669848222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3257 PONTIAC AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925094430",
            "telephone_number": "951-345-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3257 PONTIAC AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925094430",
            "telephone_number": "951-345-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASILLAS",
        "first_name": "DESIREE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "PA52968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIREE",
            "last_name": "CWICK",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.