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VILA PHOULAVAN PA-C
NPI 1184705212
Physician Assistant - Medical in Berkeley, CA

Active since October 17, 2006PECOS EnrolledAccepts Medicare Assignment
2500 MILVIA ST, BERKELEY, CA 94704(510) 204-5514 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Vila Phoulavan Pa-c NPPES

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

VILA PHOULAVAN PA-C (NPI 1184705212) is an individual medical provider in Berkeley, California, licensed in California (17855) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Corte Madera, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1184705212
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameVILA PHOULAVANCredential: PA-C
Location Address2500 MILVIA STBerkeley, CA 94704-2636
Mailing Address6220 Fairlane Dr Unit BOakland, CA 94611-1810 · (510) 735-1891
Phone(510) 204-5514
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateOctober 17, 2006
Last NPPES UpdateOctober 30, 2024
NPPES CertifiedOctober 30, 2024
✔ NPI 1184705212 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 · 17855
2500 MILVIA ST, Berkeley, CA 94704
Open in Google Maps ↗

Secondary Practice Location 1

Location 1101 Casa Buena DrCorte Madera, CA 94925-1762 · Phone (415) 924-4525

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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

Vila Phoulavan 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 ID7113962523
PECOS Enrollment IDI20050627000538
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
21 services19 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
21 services21 patients
Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus 87637
This test identifies if you have COVID-19, influenza A or B, or respiratory syncytial virus. It uses a multiplex amplified probe technique, which amplifies and detects specific genetic material of the viruses, helping in accurate diagnosis.
18 services18 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
18 services18 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
15 services15 patients

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.

LAER E. HILLARY STREETER MD, MPH
Obstetrics & Gynecology
2500 MILVIA ST
BERKELEY, CA 94704
Alameda County (510) 204-5600
ANGELYN R THOMAS M.D.
Obstetrics & Gynecology
2500 MILVIA ST
BERKELEY, CA 94704
Alameda County (510) 204-5600
STEPHANIE MICHELLE TAI FNP, MSN, RN
Nurse Practitioner (Family)
2500 MILVIA ST
BERKELEY, CA 94704
Alameda County (510) 204-5600
ROXANNE FISCELLA, M.D.
Legal Medicine
2500 MILVIA ST, SUITE 116
BERKELEY, CA 94704
Alameda County (510) 843-0692
DR. THUY THI TRAN OD
Optometrist
2500 MILVIA ST, #208
BERKELEY, CA 94704
Alameda County (510) 548-6630
PETRA FROEHLICH LANDMAN MD
Pediatrics
2500 MILVIA ST
BERKELEY, CA 94704
Alameda County (510) 204-5600
RACHEL BUDKER MD
Obstetrics & Gynecology
2500 MILVIA ST
BERKELEY, CA 94704
Alameda County (510) 204-5600
DENISE MICHELLE OCHOA NP-C
Nurse Practitioner (Family)
2500 MILVIA ST
BERKELEY, CA 94704
Alameda County (510) 204-5521

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 Vila Phoulavan's NPI number?

The NPI number for Vila Phoulavan is 1184705212. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Where is Vila Phoulavan located?

Vila Phoulavan practices at 2500 Milvia St, Berkeley, CA 94704. The listed phone number is (510) 204-5514.

What is Vila Phoulavan's specialty?

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

Is Vila Phoulavan enrolled in Medicare?

Yes. Vila Phoulavan 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 Vila Phoulavan was last updated on October 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.