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AUDREANA JUSTINE BRANCACCIO
NPI 1720866957
Physician Assistant in San Diego, CA

Active since September 19, 2023PECOS Enrolled
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105(619) 255-9155 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Audreana Justine Brancaccio NPPES

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

AUDREANA JUSTINE BRANCACCIO (NPI 1720866957) is an individual physician assistant in San Diego, California, licensed in California (PA66000) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720866957
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameAUDREANA JUSTINE BRANCACCIO
Location Address4060 FAIRMOUNT AVESan Diego, CA 92105-1608
Mailing Address4060 Fairmount AveSan Diego, CA 92105-1608 · (619) 255-9155
Phone(619) 255-9155
Sole ProprietorNo
Enumeration DateSeptember 19, 2023
Last NPPES UpdateMarch 31, 2025
NPPES CertifiedMarch 31, 2025
✔ NPI 1720866957 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · PA66000
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.
4060 FAIRMOUNT AVE, San Diego, CA 92105
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Audreana Justine Brancaccio 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 92105 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
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 20

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

DR. DORA DOAN O.D.
Optometrist
4060 FAIRMOUNT AVE, OPTOMETRY DEPARTMENT
SAN DIEGO, CA 92105
San Diego County (619) 961-0803
DIANA P ALVAREZ MSW
Counselor (Mental Health)
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 295-6047
KALEELAH RAE, NAJA MUHAMMAD
Student in an Organized Health Care Education/Training Program
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 280-4213
DR. ADLA TESSIER M.D.
Internal Medicine
4060 FAIRMOUNT AVE, FAMILY PRACTICE
SAN DIEGO, CA 92105
San Diego County (619) 255-9155
CYNTHIA MIRANDA PSYD
Psychologist
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 564-8765
TONYA DANIELLE DANIEL LCSW
Social Worker (Clinical)
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 584-1612
SAMANTHA GOGGIN MD
Pediatrics
4060 FAIRMOUNT AVE, PEDIATRICS DEPARTMENT
SAN DIEGO, CA 92105
San Diego County (619) 255-9154
NYAKOACH LAM ACSW
Social Worker
4060 FAIRMOUNT AVE
SAN DIEGO, CA 92105
San Diego County (619) 285-7097

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 Audreana Brancaccio's NPI number?

The NPI number for Audreana Brancaccio is 1720866957. It was assigned to this individual provider in the NPPES registry on September 19, 2023.

Where is Audreana Brancaccio located?

Audreana Brancaccio practices at 4060 Fairmount Ave, San Diego, CA 92105. The listed phone number is (619) 255-9155.

What is Audreana Brancaccio's specialty?

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

Is Audreana Brancaccio enrolled in Medicare?

Yes. Audreana Brancaccio is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Audreana Brancaccio was last updated on March 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.