CMS-1500 Box 24J / 33a • NPI
1306364518
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
225 W BROADWAY, GLENDALE, CA, 91204-1331
✓ 9-Digit EDI 837 ZIP+4 (91204-1331)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1306364518 (PAULINA MARIE ACEVEDO, PA-C) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1306364518)
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Betamethasone Dipropionate Betamethasone Dipropionate | 60 | 41 |
| Calcipotriene Calcipotriene | 19 | <11 |
| Cephalexin Cephalexin | 43 | 32 |
| Ciclopirox Ciclopirox | 20 | <11 |
| Clindamycin Phosphate Clindamycin Phosphate | 56 | 27 |
| Clobetasol Propionate Clobetasol Propionate | 132 | 60 |
| Doxycycline Hyclate Doxycycline Hyclate | 79 | 47 |
| Fluocinonide Fluocinonide | 52 | 30 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1306364518 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | PAULINA MARIE ACEVEDO, PA-C |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 225 W BROADWAY, GLENDALE, CA, 91204-1331 |
| Practice Telephone / Fax | Tel: (818) 545-7117 |
| Administrative Mailing Address | 2346 HARWOOD ST, LOS ANGELES, CA, 90031-1107 |
| Enumeration & Last Sync | Enumerated: 2017-09-07 | CMS Record Updated: 2026-03-24 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (PAULINA MARIE ACEVEDO, PA-C)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: CA | License: 54755 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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