Individual provider Active NPI

Lucia Padilla, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1689829210
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1085622 Issued in CA
Practice address
1061 E Vernon Ave Ste F
Los Angeles, CA 90011-3772
Phone
(323) 233-9686
Fax
(323) 233-0595
NPI assigned
Nov 24, 2008
Last updated
Nov 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1085622 CA Primary

Addresses

Primary practice location

1061 E Vernon Ave Ste F
Los Angeles, CA 90011-3772

Mailing address

1061 E Vernon Ave Ste F
Los Angeles, CA 90011-3772
Phone (323) 233-9686

Other identifiers 1

IdentifierTypeStateIssuer
1085622MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130905000823 CA Practitioner - Physician Assistant 1951544238 Reassigns benefits to 2 organizations
I20240607000981 NY Practitioner - Physician Assistant 1951544238 Reassigns benefits to 3 organizations

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
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

506 Lenox Ave
New York, NY 10037-1802
Phone (212) 939-1840

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
029017NYMDGeneral Practice Dentistry
1085622CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 9, 2019 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jul 15, 2024 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince Jul 15, 2024 Accepting new patients
East Valley Community Health Center, Inc. CurrentSince Feb 4, 2017 Accepting new patients
Health Service Alliance CurrentSince Dec 1, 2018 Accepting new patients
Clinica del Socorro Medical Group,Inc. PastSince Dec 6, 2009 Accepting new patients
Tri-State Community Healthcare Center Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

5050 San Bernardino St
Montclair, CA 91763
Phone (909) 281-5800

1555 S Garey Ave
Pomona, CA 91766
Phone (909) 620-8088

420 S Glendora Ave
West Covina, CA 91790
Phone (626) 919-5724

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

1901 1st Ave
Rm 5M44
New York, NY 10029
Phone (212) 423-6262

227 Madison St
New York, NY 10002
Phone (212) 238-7000

50 Water St
Fl 3
New York, NY 10004

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1689829210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 E VERNON AVE STE F",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113772",
            "telephone_number": "323-233-9686",
            "fax_number": "323-233-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 E VERNON AVE STE F",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113772",
            "telephone_number": "323-233-9686",
            "fax_number": "323-233-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "LUCIA",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "1085622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1085622",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.