Individual provider Active NPI

Geraldine Cabero, PA-C

  • Physician Assistant
  • Mattawa, WA
National Provider Identifier
1700314895
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60784431 Issued in WA
Practice address
601 Government Way
Mattawa, WA 99349
Phone
(509) 488-5256
Fax
(509) 488-9939
NPI assigned
Jun 1, 2017
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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 PA60784431 WA Primary

Addresses

Primary practice location

601 Government Way
Mattawa, WA 99349

Mailing address

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256

Other identifiers 1

IdentifierTypeStateIssuer
2086567MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20250717003270 NV Practitioner - Physician Assistant 5092081117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Robert West MD IncGroup PAC ID 8729990973, 141 clinicians

Practice addresses (Care Compare)

2650 N Tenaya Way
Suite 208
Las Vegas, NV 89128-1104
Phone (702) 360-2100

653 N Town Ctr Dr
Suite 214
Las Vegas, NV 89144-0516
Phone (702) 255-7924

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc CurrentSince Aug 1, 2025 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
La Laser Center PC, a Professional Medical Corporation PastSince Feb 1, 2020 Accepting new patients

Locations

2650 N Tenaya Way
Ste 208
Las Vegas, NV 89128
Phone (702) 360-2100

630 S Rancho Dr
Ste E
Las Vegas, NV 89106
Phone (702) 258-1001

653 N Town Center Dr
Ste 214
Las Vegas, NV 89144
Phone (702) 248-8989

7220 S Cimarron Rd
Ste 200250
Las Vegas, NV 89113
Phone (702) 933-0225

9780 W Skye Canyon Park Dr
#100
Las Vegas, NV 89166

Interoperability endpoints

  • Direct secure messaging: gemc@lalasercenter.emadirect.md
  • Direct secure messaging: geraldine.cabero.p1@direct.lakeside.nextgenshare.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": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1700314895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GOVERNMENT WAY",
            "city": "MATTAWA",
            "state": "WA",
            "postal_code": "99349",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABERO",
        "first_name": "GERALDINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60784431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2086567",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattawa, WA

Sources for this page

Verify at the official NPI Registry.