ANGELICA BUENROSTRO (PA-C) – Medical Physician Assistant, NPI 1720052418

ANGELICA BUENROSTRO (PA-C) is a healthcare provider. based in Fullerton, California. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA18306 (CA). The NPI Number for ANGELICA BUENROSTRO (PA-C) is 1720052418

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
ANGELICA BUENROSTRO (PA-C)
NPI
1720052418
Phone
(714) 446-5200
Address
100 E Valencia Mesa Dr Ste 310
Enumeration Date
17 February 2006
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2095365780
Graduation Year
2005 (21 years ago)
PAC ID
4183633670
Group Practice PAC ID
4284538505
Professional Enrollment ID
I20060411000523
Address ID
CA953705288SO680XXLNXX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

10,570 PHYSICIAN ASSISTANT in CA

Provider Addresses for ANGELICA BUENROSTRO (PA-C)

  • 100 E Valencia Mesa Dr Ste 310

    Fullerton, CA 92835

    Phone: (714) 446-5200

    Fax: (714) 446-5181

    Type: Location

  • 1860 S Sepulveda Blvd

    Los Angeles, CA 900254314

    Phone: (310) 473-5807

    Fax: (310) 473-5801

    Type: Location

  • 201, East Orangeburg Avenue, Modesto, Stanislaus County, California, 95350, United States

    MODESTO, CA 953505512

    Phone: (209) 572-3224

    Fax: (209) 572-4528

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-04-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060411000523IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92835)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284538505View full group profile

Reviews

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Frequently asked questions

What NPI should I save for ANGELICA BUENROSTRO (PA-C)?
Save NPI 1720052418 if you need a stable reference for ANGELICA BUENROSTRO (PA-C).
Is ANGELICA BUENROSTRO (PA-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does ANGELICA BUENROSTRO (PA-C) list a primary specialty?
If you are matching referrals, note Medical Physician Assistant for ANGELICA BUENROSTRO (PA-C). Clinical services aligned with this taxonomy classification.
What location metadata exists for ANGELICA BUENROSTRO (PA-C)?
The page summarizes Fullerton, California for ANGELICA BUENROSTRO (PA-C); expand the address list for detail.
What if Fullerton, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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