ALEXANDRA ANN CONCANNON DO
NPI 1962022343
Pediatrics in Antioch, CA
About Alexandra Ann Concannon Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALEXANDRA ANN CONCANNON DO (NPI 1962022343) is an individual pediatrics provider in Antioch, California, licensed in California (20A21118) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alexandra Ann Concannon Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Alexandra Concannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Vallejo, CA 94589
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
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 94509 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
ANTIOCH, CA 94509
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 Alexandra Concannon's NPI number?
The NPI number for Alexandra Concannon is 1962022343. It was assigned to this individual provider in the NPPES registry on April 25, 2020.
Where is Alexandra Concannon located?
Alexandra Concannon practices at 3400 Delta Fair Blvd, Antioch, CA 94509. The listed phone number is (925) 779-5000.
What is Alexandra Concannon's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Alexandra Concannon enrolled in Medicare?
Yes. Alexandra Concannon is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Alexandra Concannon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alexandra Concannon reassigns Medicare benefits to Permanente Medical Group Inc (Vallejo, 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 Alexandra Concannon'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 Alexandra Concannon was last updated on August 18, 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.
# Alexandra Ann Concannon, DO · NPI 1962022343
Pediatrics physician in Antioch, California. Individual provider, active in the CMS NPPES registry since April 25, 2020.
## Identity
- **NPI:** 1962022343 (Entity type: Individual)
- **Enumerated:** April 25, 2020
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 20A21118 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3400 DELTA FAIR BLVD, Antioch, CA 94509-4004
- **Phone:** (925) 779-5000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1336222397, Vallejo, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 18, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1962022343) · Data from the CMS NPPES public registry.