Charo Medrozo Vitug

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95020566 Issued in CA

Practice address

5401 Paularo Way
Antioch, CA 94531-5026

Phone

(252) 452-8199

NPI assigned

Jul 19, 2024

Last updated

Jul 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Post Acute Rehabilitation Physicians LLCGroup PAC ID 7214334614, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Post Acute Rehabilitation Physicians LLC

  • Physical Medicine & Rehabilitation Physician
  • Lehi, UT
  • NPI 1023781028

  CA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1720826043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 PAULARO WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945315026",
            "telephone_number": "252-452-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 PAULARO WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945315026",
            "telephone_number": "252-452-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITUG",
        "first_name": "CHARO",
        "middle_name": "MEDROZO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95020566",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95020566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl R Viesti Jr., PHD
• Karen Susan Vilca
• Villa Speranza
• Mariana Villalovoz
• Vistability
• Eric Joseph Vizcarra
• Louis Fernando Vizcarrondo
• Victoria Von Brauch, PPS
• Tona F. Von Egert
• Rekha Vontela, DDS

• Gerontology Nurse Practitioner in Antioch, CA
• Providers in Antioch, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.