Mara Kamyl Perez Custodio, PA-C
NPI 1932729829ActiveIndividual· Physician Assistant· La Jolla, CA
Physician Assistant (PA-C) with Regents of the University of California, practicing in La Jolla, California. Their prescriptions cost Medicare Part D more than their services did: $177,064 for 373 claims, against $14,402 paid for services in 2024. Abbvie Inc. reported $124.96 in payments in 2025, mostly food and beverage. Lists Uc San Diego Health Hillcrest - Hillcrest Med Ctr as a hospital affiliation.
Overview
| NPI | 1932729829 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | Yes |
| NPI issued | Apr 20, 2020 |
| Last updated in NPPES | Jan 27, 2025 |
| Certified by provider | Jan 27, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 58937 | CA |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
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 | 130 |
|---|---|
| Services billed | 228 across 12 procedure codes |
| Paid by Medicare | $14,402 |
Part D prescriptions in 2024
| Prescriptions (claims) | 373 · 566 30-day fills |
|---|---|
| Patients | 141 |
| Total drug cost | $177,064 |
| Generic share | 78% of claims |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Physician Assistant |
| Telehealth | Offers telehealth |
Medical group
- Regents of the University of CaliforniaSan Diego, CA · 2,089 clinicians
Hospital affiliation
- Uc San Diego Health Hillcrest - Hillcrest Med CtrSan Diego, CA
Industry payments (Open Payments)
- 2025$124.96 · 1 payment from 1 company
- 2024$308.67 · 5 payments from 3 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Abbvie Inc. | $124.96 | 1 |
What the 2025 payments were for
- Food and Beverage$124.96 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 149 physician assistants in La Jolla · All physician assistants in California