Individual provider Active NPI

Rachelle Gerola Cayago, PA

  • Medical Physician Assistant
  • Eagle Rock, CA
National Provider Identifier
1689826463
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA19996 Issued in CA
Practice address
1704 Colorado Blvd
Eagle Rock, CA 90041-1338
Phone
(323) 256-4116
Fax
(323) 256-4116
NPI assigned
Oct 13, 2008
Last updated
Feb 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA19996 CA Primary

Addresses

Primary practice location

1704 Colorado Blvd
Eagle Rock, CA 90041-1338

Mailing address

1704 Colorado Blvd
Eagle Rock, CA 90041-1338
Phone (323) 256-4116

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
I20121011000666 CA Practitioner - Physician Assistant 7315196102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1704 Colorado Blvd
Los Angeles, CA 90041-1338
Phone (323) 256-4116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19996CAMDMassage Therapist
PA19996CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Health Centers Inc CurrentSince Sep 24, 2012 Accepting new patients
Comprehensive Community Health Centers Inc Past Accepting new patients
Lasalle Medical Associates Past Accepting new patients

Locations

1704 Colorado Blvd
Los Angeles, CA 90041
Phone (323) 256-4116

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rachellecayago@cchc.trimed.direct-ci.com

Organizations & group practices 4

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": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1689826463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 COLORADO BLVD",
            "city": "EAGLE ROCK",
            "state": "CA",
            "postal_code": "900411338",
            "telephone_number": "323-256-4116",
            "fax_number": "323-256-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 COLORADO BLVD",
            "city": "EAGLE ROCK",
            "state": "CA",
            "postal_code": "900411338",
            "telephone_number": "323-256-4116",
            "fax_number": "323-256-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAYAGO",
        "first_name": "RACHELLE",
        "middle_name": "GEROLA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Rock, CA

Sources for this page

Verify at the official NPI Registry.