Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tivi Mauro, PAC

Individual provider Physician Assistant · NPI 1770303323

Tivi Mauro, PAC is a Physician Assistant in San Diego, California. Qualified in 2024, 2 years ago. Practices with Kevin J Pelton MD Inc, a 38-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

3910 Ingraham St Apt 14-104
San Diego, CA 92109-5906
Phone: (716) 573-6333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA65136 (CA)

Record details

NPI number1770303323
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 16, 2024
Last updated in NPPESOctober 16, 2024
Certification dateOctober 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Kevin J Pelton Md Inc — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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