Individual provider Active NPI

Elisa Yacoob Pasche, NP-C

  • Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1841060530
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F12230874 Issued in CA
Practice address
7675 Mission Valley Rd
San Diego, CA 92108-4429
Phone
(800) 316-6314
NPI assigned
Jan 4, 2024
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F12230874 CA Primary

Addresses

Primary practice location

7675 Mission Valley Rd
San Diego, CA 92108-4429

Mailing address

7675 Mission Valley Rd
San Diego, CA 92108-4429

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
I20240627002507 CA Practitioner - Nurse Practitioner 4789128091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plastic Surgery and Wound ConsultantsGroup PAC ID 3274995808, 9 clinicians

Practice addresses (Care Compare)

416 N Bedford Dr
Suite 100
Beverly Hills, CA 90210-4308
Phone (305) 951-6543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F12230874CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Plastic Surgery and Wound Consultants CurrentSince May 1, 2024 Accepting new patients

Locations

416 N Bedford Dr
Ste 100
Beverly Hills, CA 90210
Phone (305) 951-6543

Organizations & group practices 1

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": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1841060530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "800-316-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCHE",
        "first_name": "ELISA",
        "middle_name": "YACOOB",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "F12230874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.