KARISMA EDERLYN AGUSTIN EBORA
NPI 1619510872
Nurse Practitioner - Pediatrics in Ridgecrest, CA

Q: What is Karisma Ederlyn Ebora's NPI number?

The NPI number for Karisma Ederlyn Ebora is 1619510872. It was assigned to this individual provider in the NPPES registry on October 21, 2019.

Q: What is Karisma Ederlyn Ebora's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Active since October 21, 2019PECOS Enrolled

1111 N CHINA LAKE BLVD STE 190, RIDGECREST, CA 93555(760) 499-3855(760) 499-3870 Get Directions Write a Review

NPPES record last updated: May 17, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 17, 2021, Oct 21, 2019 (2 updates tracked since 2019).

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About Karisma Ederlyn Agustin Ebora NPPES

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

KARISMA EDERLYN AGUSTIN EBORA (NPI 1619510872) is an individual pediatrics provider in Ridgecrest, California, licensed in California (95012836) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619510872

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameKARISMA EDERLYN AGUSTIN EBORA

Location Address1111 N CHINA LAKE BLVD STE 190Ridgecrest, CA 93555-3131

Mailing Address1081 N China Lake BlvdRidgecrest, CA 93555-3130 · (760) 499-3855 · Fax (760) 499-3870

Phone(760) 499-3855

Fax(760) 499-3870

Sole ProprietorYes

Enumeration DateOctober 21, 2019

Last NPPES UpdateMay 17, 20212 updates tracked since enumeration

NPPES CertifiedMay 17, 2021

✔ NPI 1619510872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in CA · 95012836

Also ListedRegistered NurseTaxonomy 163W00000X · License 95194733 (CA)

1111 N CHINA LAKE BLVD STE 190, Ridgecrest, CA 93555

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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 (PECOS)

Karisma Ederlyn Agustin Ebora 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93555 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

$91.09 typical visit price

range $59.26 – $178.09

Typical copayment $22.77 (range $14.81 – $44.52)

Most-billed visit code 99203

Established Patient

$104.09 typical visit price

range $19.34 – $145.64

Typical copayment $26.02 (range $4.83 – $36.41)

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 14

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

KELLY ANN DOTY PA

Physician Assistant