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AUDREY JEAN DASILVA
NPI 1548897119
Pediatrics in South Lake Tahoe, CA

Active since March 24, 2020PECOS Enrolled
2201 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150(530) 543-5550 Get Directions Write a Review

NPPES record last updated: June 13, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 13, 2023, May 7, 2021, Mar 24, 2020 (3 updates tracked since 2020).

About Audrey Jean Dasilva NPPES

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

AUDREY JEAN DASILVA (NPI 1548897119) is an individual pediatrics provider in South Lake Tahoe, California, licensed in California (A182796) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548897119
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameAUDREY JEAN DASILVA
Location Address2201 SOUTH AVESouth Lake Tahoe, CA 96150-7025
Mailing Address2201 South AveSouth Lake Tahoe, CA 96150-7025
Phone(530) 543-5550
Sole ProprietorNo
Enumeration DateMarch 24, 2020
Last NPPES UpdateJune 13, 20233 updates tracked since enumeration
NPPES CertifiedJune 13, 2023
✔ NPI 1548897119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in CA · A182796✔ Licensed in CA · PTL3653
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2201 SOUTH AVE, South Lake Tahoe, CA 96150
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Other Names 1

Former Name (1)Audrey Jean Nichols

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Audrey Jean Dasilva 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.

Medicare Billing Reassignment

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

Barton Medical Foundation
0.1 mi
Family Medicine
2170 SOUTH AVE
South Lake Tahoe, CA 96150
  • Reassigned Medicare billing, California enrollment
  • 148 clinicians in this Medicare group
NPI 1750950499 (530) 541-3420

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96150 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
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 20

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

MARGARET VIEIRA
Nurse Practitioner (Family)
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
BARTON HEALTHCARE SYSTEM
Clinic/Center (Rural Health)
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
JACQUELYN NOEL SARTORIUS PA-C
Physician Assistant
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
DR. MATTHEW PAUL WONNACOTT MD
Family Medicine
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
ANNA MARIE PETERSEN FNP-BC
Nurse Practitioner (Primary Care)
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
CATHERINE GAEHWILER PA
Physician Assistant
2201 SOUTH AVE, STE B
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
DR. PAUL WILLIAM RORK MD
Family Medicine
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
TODD WILLIAM DEGIOVANNI PA-C
Physician Assistant
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623

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 Audrey Dasilva's NPI number?

The NPI number for Audrey Dasilva is 1548897119. It was assigned to this individual provider in the NPPES registry on March 24, 2020. The provider is also known as Audrey Jean Nichols.

Where is Audrey Dasilva located?

Audrey Dasilva practices at 2201 South Ave, South Lake Tahoe, CA 96150. The listed phone number is (530) 543-5550.

What is Audrey Dasilva's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Audrey Dasilva enrolled in Medicare?

Yes. Audrey Dasilva is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Audrey Dasilva's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Audrey Dasilva reassigns Medicare benefits to Barton Medical Foundation (South Lake Tahoe, 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 Audrey Dasilva'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 Audrey Dasilva was last updated on June 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.