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ALYSSA SAN DIEGO PA-C
NPI 1194593376
Physician Assistant in Davenport, FL

Active since December 18, 2023PECOS EnrolledAccepts Medicare Assignment
2310 NORTH BLVD W STE A, DAVENPORT, FL 33837(813) 701-5804 Get Directions Write a Review

NPPES record last updated: March 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alyssa San Diego Pa-c NPPES

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

ALYSSA SAN DIEGO PA-C (NPI 1194593376) is an individual physician assistant in Davenport, Florida and active in the NPI registry since December 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1194593376
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameALYSSA SAN DIEGOCredential: PA-C
Location Address2310 NORTH BLVD W STE ADavenport, FL 33837-8988
Mailing Address2672 Patrician CirKissimmee, FL 34746-3292
Phone(813) 701-5804
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 18, 2023
Last NPPES UpdateMarch 2, 2025
NPPES CertifiedMarch 2, 2025
✔ NPI 1194593376 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.
2310 NORTH BLVD W STE A, Davenport, FL 33837
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

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

Alyssa San Diego 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 ID8820525504
PECOS Enrollment IDI20241218004302
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 33837 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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 4

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

NEAL SHAH MD
Anesthesiology (Pain Medicine)
2310 NORTH BLVD W STE A
DAVENPORT, FL 33837
Polk County (813) 701-5804
DR. MAXIME G GEDEON M.D.
Anesthesiology (Pain Medicine)
2310 NORTH BLVD W STE A
DAVENPORT, FL 33837
Polk County (813) 701-5804
EXCEL PAIN AND SPINE LLC
Physical Medicine & Rehabilitation (Pain Medicine)
2310 NORTH BLVD W STE A
DAVENPORT, FL 33837
Polk County (813) 701-5804
TOTAL PAIN AND SPINE CARE OF FLORIDA LLC
Pain Medicine (Interventional Pain Medicine)
2310 NORTH BLVD W STE A
DAVENPORT, FL 33837
Polk County (863) 732-7246

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 Alyssa San Diego's NPI number?

The NPI number for Alyssa San Diego is 1194593376. It was assigned to this individual provider in the NPPES registry on December 18, 2023.

Where is Alyssa San Diego located?

Alyssa San Diego practices at 2310 North Blvd W Ste A, Davenport, FL 33837. The listed phone number is (813) 701-5804.

What is Alyssa San Diego's specialty?

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

Is Alyssa San Diego enrolled in Medicare?

Yes. Alyssa San Diego 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.

What insurance does Alyssa San Diego accept?

Health plans from AvMed list Alyssa San Diego as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Alyssa San Diego was last updated on March 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.