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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: August 16, 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
Phone(804) 715-4709
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
Open in Google Maps ↗

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.

KATRI ANN FRENCH FNP-BC
Nurse Practitioner (Family)
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 796-2373
DOUGLAS E BECKWITH MD
Family Medicine
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 796-2373
ROBERT WAYNE RHOADES DO
Anesthesiology
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 715-4709
CHRISTOPHER MILLER M.D.
Family Medicine
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 796-2373
SHAWN MICHAEL REID NP
Nurse Practitioner (Family)
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 796-2373
INTERVENTIONAL PAIN & SPINE SPECIALISTS, PLLC
Pain Medicine (Pain Medicine)
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 715-4709
CHESTER FAMILY MEDCARE PC
Family Medicine
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 796-2373
KEVIN FRANKLIN DUNIVAN AGAC-NP
Nurse Practitioner (Acute Care)
12901 BRIGGS RD
CHESTER, VA 23831
Chesterfield County (804) 715-4709

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 Carol Cdebaca's NPI number?

The NPI number for Carol Cdebaca is 1154518900. It was assigned to this individual provider in the NPPES registry on September 26, 2007.

Where is Carol Cdebaca located?

Carol Cdebaca practices at 12901 Briggs Rd, Chester, VA 23831. The listed phone number is (804) 715-4709.

What is Carol Cdebaca's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Carol Cdebaca enrolled in Medicare?

Yes. Carol Cdebaca is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Carol Cdebaca was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.