Individual provider Active NPI

Patricia Ann Vlasin, FNP

  • Gerontology Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1871635391
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP 9662 Issued in CA
Practice address
9921 Carmel Mountain Rd
#430
San Diego, CA 92129-2813
Phone
(619) 602-6351
Fax
(858) 901-4873
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP 9662 CA Primary

Addresses

Primary practice location

9921 Carmel Mountain Rd
#430
San Diego, CA 92129-2813

Mailing address

9921 Carmel Mountain Rd
#430
San Diego, CA 92129-2813
Phone (619) 602-6351

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
I20100209000471 CA Practitioner - Nurse Practitioner 5092858381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

909 Richland Rd
SPC 91
San Marcos, CA 92069-9629
Phone (619) 602-6351

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP 9662CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Vlasin, N.P., Inc., a Nursing Corporation Gerontology CurrentSince May 25, 2017 Accepting new patients
San Luis Rey Medical Group CurrentSince Jul 21, 2025 Accepting new patients
Mobile Medical Group Past Accepting new patients

Locations

6400 Oak Cyn
Ste 200
Irvine, CA 92618
Phone (949) 240-7200

9921 Carmel Mountain Rd
San Diego, CA 92129
Phone (619) 602-6351

27710 Jefferson Ave
Ste 207
Temecula, CA 92590
Phone (833) 668-6676

Organizations & group practices 3

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 1

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1871635391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 CARMEL MOUNTAIN RD",
            "address_2": "#430",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "619-602-6351",
            "fax_number": "858-901-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9921 CARMEL MOUNTAIN RD",
            "address_2": "#430",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292813",
            "telephone_number": "619-602-6351",
            "fax_number": "858-901-4873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLASIN",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP 9662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.