MS. CAROL SUE CDEBACA PA-C
NPI 1154518900
Physician Assistant - Surgical in Chester, VA

Active since September 26, 2007PECOS Enrolled
12901 BRIGGS RD, CHESTER, VA 23831(804) 715-4709(804) 715-4709 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Carol Sue Cdebaca Pa-c NPPES

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

MS. CAROL SUE CDEBACA PA-C (NPI 1154518900) is an individual surgical provider in Chester, Virginia, licensed in Virginia (0110002628) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154518900
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMS. CAROL SUE CDEBACACredential: PA-C
Location Address12901 BRIGGS RDChester, VA 23831-5335
Mailing Address12901 Briggs RdChester, VA 23831-5335 · (804) 715-4709 · Fax (804) 715-4714
Fax(804) 715-4709
Sole ProprietorNo
Enumeration DateSeptember 26, 2007
Last NPPES UpdateApril 23, 2025
NPPES CertifiedApril 23, 2025
NPI 1154518900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in VA · 0110002628
12901 BRIGGS RD, Chester, VA 23831

Other Identifiers 10

Other1154518900VA · Southern Health/carenet/carelink/coventry
OtherP01464014VA · Railroad Medicare
Other1154518900VA · Humana Medicare
Other540506332115VA · Tricare
Other1154518900VA · In Total
Other1154518900VA · Optima Health Plan
Other1154518900VA · Aetna
Other1154518900VA · Ccc Virginia Premier
Other1154518900VA · Medicaid Qmb
Other1154518900VA · Anthem Medigap

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Ms. Carol Sue Cdebaca Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

Family Medicine
12901 BRIGGS RD
CHESTER, VA 23831
Nurse Practitioner (Family)
12901 BRIGGS RD
CHESTER, VA 23831
Family Medicine
12901 BRIGGS RD
CHESTER, VA 23831
Family Medicine
12901 BRIGGS RD
CHESTER, VA 23831
Nurse Practitioner (Family)
12901 BRIGGS RD
CHESTER, VA 23831
Nurse Practitioner (Family)
12901 BRIGGS RD
CHESTER, VA 23831
Family Medicine
12901 BRIGGS RD
CHESTER, VA 23831
Anesthesiology
12901 BRIGGS RD
CHESTER, VA 23831

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154518900, enumerated as an "individual" on September 26, 2007.

The provider is located at 12901 BRIGGS RD CHESTER, VA 23831 and the phone number is (804) 715-4709.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

The provider might be accepting Accepts: Medicare, Medicaid, Railroad Medicare, Humana,. Please consult your insurance carrier or call the provider to verify.