Individual provider Active NPI

Maria Veronica Serratos Valdivia

  • Medical Physician Assistant
  • Watsonville, CA
National Provider Identifier
1730709049
Registry record updated Aug 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
58975 Issued in CA
Practice address
575 Auto Center Dr
Watsonville, CA 95076-3727
Phone
(831) 288-6537
Fax
(831) 722-2855
NPI assigned
Apr 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2023

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 58975 CA Primary

Addresses

Primary practice location

575 Auto Center Dr
Watsonville, CA 95076-3727

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210104000230 CA Practitioner - Physician Assistant 7810300217 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
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1595 Soquel Dr
Santa Cruz, CA 95065-1724

575 Auto Ctr Dr
Watsonville, CA 95076-3727
Phone (831) 288-6537

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58975CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Feb 1, 2023 Accepting new patients

Locations

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

575 Auto Center Dr
Watsonville, CA 95076
Phone (831) 288-6537

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.

Hospital & facility affiliations 2

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": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692489600000",
    "number": "1730709049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 AUTO CENTER DR",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763727",
            "telephone_number": "831-288-6537",
            "fax_number": "831-722-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRATOS VALDIVIA",
        "first_name": "MARIA",
        "middle_name": "VERONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-08-20",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "58975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.