Carrie M. Carrillo, PA
NPI 1588872089ActiveIndividual· Physician Assistant, Surgical· Fullerton, CA
Physician Assistant, Surgical (PA) with Providence Medical Foundation, practicing in Fullerton, California. 208 Medicare patients in 2024, $23,737 paid; nearly all of their 493 Part D prescriptions were generic (99%). Lists Providence St. Jude Medical Center as a hospital affiliation.
Overview
| NPI | 1588872089 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA |
| Sole proprietor | No |
| NPI issued | May 18, 2007 |
| Last updated in NPPES | Oct 20, 2021 |
| Certified by provider | Oct 20, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | PA17561 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 208 |
|---|---|
| Services billed | 1,135 across 36 procedure codes |
| Paid by Medicare | $23,737 |
Part D prescriptions in 2024
| Prescriptions (claims) | 493 · 493 30-day fills |
|---|---|
| Patients | 201 |
| Total drug cost | $3,749 |
| Generic share | 99% of claims |
Education and affiliations
| Graduation year | 2004 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Providence Medical FoundationVictorville, CA · 1,466 clinicians
Hospital affiliation
- Providence St. Jude Medical CenterFullerton, 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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All 16 surgical physician assistants in Fullerton · All surgical physician assistants in California