Holly K. Fanning, PA
NPI 1104387448ActiveIndividual· Physician Assistant, Medical· La Jolla, CA
Physician Assistant, Medical (PA) with Southeastern Intensivist Services PC, practicing in La Jolla, California. Their prescriptions cost Medicare Part D more than their services did: $7,414 for 115 claims, against $1,978 paid for services in 2024. Lists Henrico Doctors' Hospital and 1 other hospital as hospital affiliations.
Overview
| NPI | 1104387448 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | No |
| NPI issued | Mar 28, 2019 |
| Last updated in NPPES | Jan 4, 2023 |
| Certified by provider | Jan 4, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | PA60834 | CA |
| Physician Assistant, Medical | 363AM0700X | 023260 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (VA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 21 |
|---|---|
| Services billed | 26 across 8 procedure codes |
| Paid by Medicare | $1,978 |
Part D prescriptions in 2024
| Prescriptions (claims) | 115 · 142 30-day fills |
|---|---|
| Patients | 42 |
| Total drug cost | $7,414 |
| Generic share | 95% of claims |
Education and affiliations
| Graduation year | 2018 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Southeastern Intensivist Services PCWoodbridge, VA · 232 clinicians
Hospital affiliations
- Henrico Doctors' HospitalRichmond, VA
- Scripps Green HospitalLa Jolla, CA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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