Carlos Rodolfo Bocanegra Cordova, PA-C
NPI 1376166264ActiveIndividual· Physician Assistant· Champaign, IL
Physician Assistant (PA-C) with Carle Health Care Incorporated, practicing in Champaign, Illinois. 140 Medicare patients in 2024, $6,369 paid; nearly all of their 185 Part D prescriptions were generic (92%). Lists Carle Foundation Hospital as a hospital affiliation.
Overview
| NPI | 1376166264 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | May 26, 2020 |
| Last updated in NPPES | Jun 17, 2020 |
| Certified by provider | Jun 17, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 085.007669 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 140 |
|---|---|
| Services billed | 151 across 8 procedure codes |
| Paid by Medicare | $6,369 |
Part D prescriptions in 2024
| Prescriptions (claims) | 185 · 198 30-day fills |
|---|---|
| Patients | 135 |
| Total drug cost | $2,083 |
| Generic share | 92% of claims |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Carle Health Care IncorporatedUrbana, IL · 1,666 clinicians
Hospital affiliation
- Carle Foundation HospitalUrbana, IL
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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