Individual provider Active NPI

Carol Veneracion-Godoy, PA-C

  • Physician Assistant
  • Downey, CA
National Provider Identifier
1760653885
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19520 Issued in CA
Practice address
8706 Imperial Hwy
Downey, CA 90242-3906
Phone
(562) 923-8300
Fax
(562) 923-8334
NPI assigned
Mar 17, 2008
Last updated
Jul 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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 PA19520 CA Primary

Addresses

Primary practice location

8706 Imperial Hwy
Downey, CA 90242-3906

Mailing address

8706 Imperial Hwy
Downey, CA 90242-3906
Phone (562) 923-8300

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
I20130821000375 CA Practitioner - Physician Assistant 8022251156 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5979 Atlantic Ave
Long Beach, CA 90805-3510
Phone (562) 423-0421

8706 Imperial Hwy
Downey, CA 90242-3906
Phone (213) 792-0334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners, a Medical Group, Inc CurrentSince Aug 26, 2017 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince Aug 26, 2017 Accepting new patients
Hanford Community Hospital Past Accepting new patients
Prohealth Partners, a Medical Group, Inc. Past Accepting new patients

Locations

8706 Imperial Hwy
Downey, CA 90242
Phone (562) 923-8300

711 E Rosecrans Ave
East Rancho Dominguez, CA 90221
Phone (310) 635-5223

12131 Carson St
Hawaiian Gardens, CA 90716
Phone (562) 809-0299

5979 Atlantic Ave
Long Beach, CA 90805
Phone (562) 423-0421

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1760653885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8706 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423906",
            "telephone_number": "562-923-8300",
            "fax_number": "562-923-8334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8706 IMPERIAL HWY",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902423906",
            "telephone_number": "562-923-8300",
            "fax_number": "562-923-8334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENERACION-GODOY",
        "first_name": "CAROL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.