CARLO RAPHAEL FULGENCIO ESCUDERO PA-C
NPI 1053918011
Physician Assistant in San Diego, CA

Q: What is Carlo Raphael Escudero's NPI number?

The NPI number for Carlo Raphael Escudero is 1053918011. It was assigned to this individual provider in the NPPES registry on October 2, 2020.

Q: What is Carlo Raphael Escudero's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since October 02, 2020PECOS EnrolledAccepts Medicare Assignment

5575 RUFFIN RD STE 100, SAN DIEGO, CA 92123(858) 277-2744 Get Directions Write a Review

NPPES record last updated: December 14, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 14, 2021, Oct 2, 2020 (2 updates tracked since 2020).

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About Carlo Raphael Fulgencio Escudero Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLO RAPHAEL FULGENCIO ESCUDERO PA-C (NPI 1053918011) is an individual physician assistant in San Diego, California and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1053918011

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameCARLO RAPHAEL FULGENCIO ESCUDEROCredential: PA-C

Location Address5575 RUFFIN RD STE 100San Diego, CA 92123-1361

Mailing Address5575 Ruffin Rd Ste 100San Diego, CA 92123-1361

Phone(858) 277-2744

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateOctober 2, 2020

Last NPPES UpdateDecember 14, 20212 updates tracked since enumeration

NPPES CertifiedDecember 11, 2021

✔ NPI 1053918011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

5575 RUFFIN RD STE 100, San Diego, CA 92123

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carlo Raphael Fulgencio Escudero Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355761644

PECOS Enrollment IDI20201027001360

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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