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NIKA CARRILLO
NPI 1508390618
Student in an Organized Health Care Education/Training Program in San Leandro, CA

Active since April 14, 2017PECOS EnrolledAccepts Medicare Assignment
2500 MERCED ST, SAN LEANDRO, CA 94577(510) 454-2000 Get Directions Write a Review

NPPES record last updated: February 24, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Nika Carrillo NPPES

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

NIKA CARRILLO (NPI 1508390618) is an individual student in an organized health care education/training program in San Leandro, California and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (2019).

NPPES Registry Identity

NPI1508390618
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameNIKA CARRILLO
Location Address2500 MERCED STSan Leandro, CA 94577-4201
Mailing Address2500 Merced StSan Leandro, CA 94577-4201 · (510) 454-1000
Phone(510) 454-2000
Sole ProprietorNo
Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 2019
Enumeration DateApril 14, 2017
Last NPPES UpdateFebruary 24, 2024
NPPES CertifiedFebruary 7, 2024
✔ NPI 1508390618 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2500 MERCED ST, San Leandro, CA 94577
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nika Carrillo 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 ID749698009
PECOS Enrollment IDI20231025003744
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 Billing Reassignment

Medicare enrollment records show Nika Carrillo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
15 mi
Internal Medicine
1190 VETERANS BLVD
Redwood City, CA 94063
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1639252604 (650) 299-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

DR. SHIENA SHARMA MD
Anesthesiology
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 454-1000
ANTHONY MICHAEL BATTAGLIA RN
Registered Nurse
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 454-1000
DR. ELIZABETH MACERA N.P.
Nurse Practitioner
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 454-1000
MS. TSUI TAM PHARM. D.
Pharmacist
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 454-2747
JEFFREY LI M.D.
Radiology (Diagnostic Radiology)
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 737-3032
CHIN-HSIANG FENG
Emergency Medicine
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 518-5598
MS. JESSICA RAE MARTINEZ CNM
Advanced Practice Midwife
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (925) 548-4751
DR. GRACE MINDY LEE M.D.
Emergency Medicine
2500 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 454-1000

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 Nika Carrillo's NPI number?

The NPI number for Nika Carrillo is 1508390618. It was assigned to this individual provider in the NPPES registry on April 14, 2017.

Where is Nika Carrillo located?

Nika Carrillo practices at 2500 Merced St, San Leandro, CA 94577. The listed phone number is (510) 454-2000.

What is Nika Carrillo's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Nika Carrillo enrolled in Medicare?

Yes. Nika Carrillo 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.

Which organization bills Medicare for Nika Carrillo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nika Carrillo reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nika Carrillo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nika Carrillo was last updated on February 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.