MISS AUTUMN LECI FORNASERO M.S. PA-C
NPI 1124300959
Physician Assistant - Medical in Brawley, CA

Active since September 19, 2011PECOS EnrolledAccepts Medicare Assignment
94.62/100
CMS Quality Rating
207 W LEGION RD, BRAWLEY, CA 92227(760) 351-3333 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Miss Autumn Leci Fornasero M.s. Pa-c NPPES

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

MISS AUTUMN LECI FORNASERO M.S. PA-C (NPI 1124300959) is an individual medical provider in Brawley, California, licensed in California (PA21802) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1124300959
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMISS AUTUMN LECI FORNASEROCredential: M.S. PA-C
Location Address207 W LEGION RDBrawley, CA 92227-7780
Mailing Address207 W Legion RdBrawley, CA 92227-7780 · (760) 351-3333
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateSeptember 19, 2011
Last NPPES UpdateDecember 6, 2021
NPI 1124300959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in CA · PA21802
207 W LEGION RD, Brawley, CA 92227

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

Miss Autumn Leci Fornasero M.s. 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 ID1557534724
PECOS Enrollment IDI20111103000313
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.67
Improvement Activities40
Cost97.14

Other Providers at the Same Location NPPES 20

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

Physician Assistant
207 W LEGION RD
BRAWLEY, CA 92227
General Acute Care Hospital
207 W LEGION RD
BRAWLEY, CA 92227
Emergency Medicine
207 W LEGION RD
BRAWLEY, CA 92227
Nurse Anesthetist, Certified Registered
207 W LEGION RD
BRAWLEY, CA 92227
Radiology (Vascular & Interventional Radiology)
207 W LEGION RD
BRAWLEY, CA 92227
Orthopaedic Surgery
207 W LEGION RD
BRAWLEY, CA 92227
Internal Medicine (Interventional Cardiology)
207 W LEGION RD
BRAWLEY, CA 92227
General Acute Care Hospital
207 W LEGION RD
BRAWLEY, CA 92227

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Autumn Fornasero's NPI number?

The NPI number for Autumn Fornasero is 1124300959. It was assigned to this individual provider in the NPPES registry on September 19, 2011.

Where is Autumn Fornasero located?

Autumn Fornasero practices at 207 W Legion Rd, Brawley, CA 92227. The listed phone number is (760) 351-3333.

What is Autumn Fornasero's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Autumn Fornasero enrolled in Medicare?

Yes. Autumn Fornasero is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Autumn Fornasero was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.