Carolyn J Vaughn, MD
Plastic and Reconstructive Surgery · San Jose
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- 19
- 4 carriers
- Office
- 1
Offices
1 location · County of Santa Clara · 1,000 clinicians in this group
Looking this up.
Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.
Plans that list them
19 plans · 4 carriers
A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Vaughn’s office at (408) 885-5000 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.
19 of 19 plans
| Alignment Health BreathEasy (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Clarity (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Harmony (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes CalPlus (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Heart & Diabetes Choice (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Honor+ Plan (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health My Choice CalCare (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Silicon (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health smartHMO (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health the ONE (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | Anthem Blue Cross | Listed | Oct 3, 2026 |
| Anthem Medicare Advantage (HMO-POS) | Anthem Blue Cross | Listed | Oct 3, 2026 |
| SCAN Balance (HMO C-SNP) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN Classic (HMO) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN MyChoice (HMO) | SCAN Health Plan | Listed | Oct 3, 2026 |
| SCAN Strive (HMO C-SNP) | SCAN Health Plan | Listed | Oct 3, 2026 |
| DualConnect (HMO D-SNP) | Santa Clara Family Health Plan | Listed | Sep 1, 2026 |
California Medical Board record
Licence A123892 · Current
Licensed to practise in California · since 2012 · expires 2028-10-31 · University of Massachusetts Medical School.
No disciplinary actions, convictions, malpractice judgments or citations in this record.
Hospitals they work in
1 hospital
These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.
- Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend itOverall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center
Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.
| SSI - Colon SurgeryInfections | 2.572 | Worse | Oct 2024 – Sep 2025 |
| Central Line Associated Bloodstream Infection (ICU + select Wards)Infections | 0.563 | Better | Oct 2024 – Sep 2025 |
| Clostridium Difficile (C.Diff)Infections | 0.256 | Better | Oct 2024 – Sep 2025 |
| MRSA BacteremiaInfections | 0.369 | Better | Oct 2024 – Sep 2025 |
| Abdominopelvic accidental puncture or laceration rateComplications and deaths | 1.25 (0.3 to 2.2) · 1,535 cases | No different | Jul 2022 – Jun 2024 |
| CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths | 1.07 (0.76 to 1.38) | No different | Jul 2022 – Jun 2024 |
| Death rate among surgical inpatients with serious treatable complicationsComplications and deaths | 214.59 (167.38 to 261.8) · 108 cases | No different | Jul 2022 – Jun 2024 |
| Death rate for CABG surgery patientsComplications and deaths | 2.8 · 41 cases | None | Jul 2022 – Jun 2025 |
| Death rate for COPD patientsComplications and deaths | 6 · 141 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart attack patientsComplications and deaths | 10.2 · 124 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart failure patientsComplications and deaths | 8.3 · 501 cases | None | Jul 2022 – Jun 2025 |
| Death rate for pneumonia patientsComplications and deaths | 14.9 · 653 cases | None | Jul 2022 – Jun 2025 |
| Death rate for stroke patientsComplications and deaths | 10.1 · 348 cases | None | Jul 2023 – Jun 2025 |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths | 3 · 4,502 cases | None | Jul 2024 – Jun 2025 |
| Iatrogenic pneumothorax rateComplications and deaths | 0.24 (0.04 to 0.43) · 9,014 cases | No different | Jul 2022 – Jun 2024 |
| In-hospital fall-associated fracture rateComplications and deaths | 0.34 (0.15 to 0.52) · 9,216 cases | No different | Jul 2022 – Jun 2024 |
| Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths | 4.54 (2.51 to 6.58) · 1,421 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative acute kidney injury requiring dialysis rateComplications and deaths | 1.54 (0 to 3.2) · 288 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative hemorrhage or hematoma rateComplications and deaths | 2.11 (0.66 to 3.56) · 1,446 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative respiratory failure rateComplications and deaths | 11.61 (4.09 to 19.14) · 294 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative sepsis rateComplications and deaths | 7.29 (3.39 to 11.2) · 299 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative wound dehiscence rateComplications and deaths | 1.9 (0.45 to 3.36) · 333 cases | No different | Jul 2022 – Jun 2024 |
| Pressure ulcer rateComplications and deaths | 0.23 (0 to 0.78) · 7,538 cases | No different | Jul 2022 – Jun 2024 |
| Rate of complications for hip/knee replacement patientsComplications and deaths | 5.4 · 94 cases | None | Apr 2023 – Mar 2025 |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections | 0.735 | No different | Oct 2024 – Sep 2025 |
| SSI - Abdominal HysterectomyInfections | 2.573 | No different | Oct 2024 – Sep 2025 |
| Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits | 14.6 · 185 cases | None | Jul 2023 – Jun 2025 |
| Heart failure (HF) 30-Day Readmission RateUnplanned return visits | 22.1 · 951 cases | None | Jul 2023 – Jun 2025 |
| Hospital return days for heart attack patientsUnplanned return visits | 56.3 · 128 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for heart failure patientsUnplanned return visits | 6.4 · 644 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for pneumonia patientsUnplanned return visits | 1.3 · 699 cases | None | Jul 2022 – Jun 2025 |
| Pneumonia (PN) 30-Day Readmission RateUnplanned return visits | 16.3 · 921 cases | None | Jul 2023 – Jun 2025 |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits | 5.7 (3.9 to 8.1) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits | 12.6 (9.4 to 16.5) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of readmission after hip/knee replacementUnplanned return visits | 5.4 · 94 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for CABGUnplanned return visits | 11.4 · 54 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits | 20.3 · 242 cases | None | Jul 2023 – Jun 2025 |
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits | 13.2 (9.9 to 17.4) · 702 cases | No different | Jan 2022 – Dec 2024 |
| Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits | 1 (0.7 to 1.4) · 195 cases | No different | Jan 2024 – Dec 2024 |
What patients said (4,032 patients answered, 29% of those asked)
| Cleanliness | 3 |
| Nurse communication | 3 |
| Doctor communication | 3 |
| Communication about medicines | 3 |
| Discharge information | 2 |
| Overall hospital rating | 3 |
| Quietness | 2 |
| Recommend hospital | 4 |
| Room was "always" clean | 70% |
| Nurses "always" communicated well | 73% |
| Doctors "always" communicated well | 76% |
| Staff "always" explained | 57% |
| Yes, staff "did" give patients this information | 82% |
| Yes, staff "did" give patients information about help after discharge | 82% |
| Doctors "always" explained things so they could understand | 71% |
| Doctors "always" listened carefully | 74% |
| Doctors "always" treated them with courtesy and respect | 82% |
| Patients who gave a rating of "9" or "10" (high) | 67% |
| Staff "always" explained new medications | 71% |
| Nurses "always" explained things so they could understand | 71% |
| Nurses "always" listened carefully | 69% |
| Nurses "always" treated them with courtesy and respect | 80% |
| "Always" quiet at night | 43% |
| "YES", patients would definitely recommend the hospital | 70% |
| Staff "always" explained possible side effects | 44% |
| Yes, staff "did" give patients information about possible symptoms | 83% |
Original Medicare doctor bills
$11,736
Medicare paid this office $11,736 for 23 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
Procedures Medicare counted
| Melanoma (skin cancer) excision | 1-10 | None |
| Removal of tissue | 1-10 | None |
Who their Medicare patients are
23 Original Medicare patients in 2024. Average age 68 · Women 52% · Health risk score 1.29. Above the middle of the specialty; the typical plastic and reconstructive surgery clinician is at 1.21.
Conditions among them: High blood pressure 70%.
The office billed $159,143, Medicare allowed $15,361 and paid $11,736; for 76 services of 28 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 23 | 76 | 68 | 1.29 | $159,143 | $11,736 |
| 2023 | 30 | 59 | 67 | 1.97 | $184,304 | $11,848 |
| 2022 | 48 | 98 | 67 | 2.17 | $214,654 | $16,653 |
| 2021 | 42 | 98 | 68 | 1.99 | $167,302 | $15,824 |
| 2020 | 48 | 113 | 65 | 2.01 | $207,241 | $16,032 |
| 2019 | 44 | 95 | 69 | 1.28 | $228,856 | $18,800 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 1 service
| Short return visit | 12 | $376 | $29 |
2022: 2 services
| Return visit (30+ min) | 27 | $2,474 | $88 |
| Short return visit | 11 | $540 | $32 |
2021: 2 services
| Short return visit (20+ min) | 21 | $1,723 | $62 |
| Return visit (30+ min) | 15 | $1,322 | $88 |
2020: 2 services
| Return visit (30+ min) | 17 | $1,046 | $62 |
| Short return visit (20+ min) | 13 | $705 | $37 |
2019: 1 service
| New patient visit (45+ min) | 11 | $1,034 | $94 |
Medicaid work
$3,948 in 2024
Medicaid paid $3,948 for 630 billed services this clinician did in 2024, up to 31 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| OFF/OP CNSLTJ NEW/EST MOD 40 | 108 | $2,832 |
| Short return visit | 62 | $787 |
| Short return visit (20+ min) | 14 | $329 |
| Medication list documented in medical record (COA) | 160 | $0 |
| Most recent systolic blood pressure less than 130 mm Hg (DM) (HTN, CKD, CAD) | 146 | $0 |
| Most recent diastolic blood pressure less than 80 mm Hg (HTN, CKD, CAD) (DM) | 140 | $0 |
| 2024 | 630 | 6 | 31 | $3,948 |
| 2023 | 207 | 3 | 19 | $1,577 |
| 2022 | 289 | 3 | 21 | $6,098 |
| 2021 | 313 | 3 | 40 | $3,681 |
| 2020 | 131 | 2 | 19 | $2,248 |
| 2019 | 112 | 3 | 27 | $100 |
See the largest Medicaid services in earlier years
2023
| OFF/OP CNSLTJ NEW/EST MOD 40 | 65 | $814 |
| Short return visit | 91 | $526 |
| Short return visit (20+ min) | 51 | $236 |
2022
| OFF/OP CNSLTJ NEW/EST MOD 40 | 193 | $4,827 |
| Short return visit | 82 | $793 |
| Service | 14 | $477 |
2021
| Short return visit (20+ min) | 282 | $3,051 |
| OFF/OP CNSLTJ NEW/EST MOD 40 | 18 | $404 |
| Return visit (30+ min) | 13 | $225 |
2020
| New patient visit (30+ min) | 44 | $1,194 |
| Short return visit (20+ min) | 87 | $1,054 |
2019
| Return visit (30+ min) | 74 | $81 |
| Short return visit (20+ min) | 26 | $19 |
| New patient visit (45+ min) | 12 | $0 |
Money from drug and device companies
$254 in 2025
| 2025 | 2 | 3 | None | $254 |
| 2022 | 2 | 3 | None | $165 |
| 2020 | 1 | 1 | None | $120 |
| 2019 | 6 | 40 | None | $3,537 |
Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.
A payment is not proof that care is biased.
| Alafair Biosciences | Versawrap | $154 | 2 payments
|
| Integra LifeSciences | Integra | $100 | 1 payment
|
See all 3 published payments
| Integra LifeSciences | Meals · 2025-11-19 | Integra | $100 |
| Alafair Biosciences | Meals · 2025-05-07 | Versawrap | $7 |
| Alafair Biosciences | Meals · 2025-03-25 | Versawrap | $147 |
See earlier years (2022, 2020, 2019)
2022: $165
| Axogen | Avance Nerve Graft | $118 | 1 payment
|
| Checkpoint Surgical | Checkpoint Stimulators | $48 | 1 payment
|
2020: $120
| Integra LifeSciences | Bilayer Wound Matrix (Bwm) | $120 | 1 payment
|
2019: $3,537
| Axogen | Axoguard Nerve Connector | $3,143 | 26 payments
|
| Endo Pharmaceuticals | Xiaflex | $200 | 1 payment
|
| Medical Device Business Services | Headless Compression Screws | $114 | 1 payment
|
| Osiris Therapeutics | Stravix | $40 | 1 payment
|
| Medela | None | $21 | 1 payment
|
| Bioventus | Exogen | $20 | 1 payment
|
Checkups this office reported
Medicare did not publish checkup rates for this clinician.
- Medicare’s overall office score
- 80.6 / 100
- Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.
Professional record
- NPI
- 1336448554
- Licence
- CA A123892California A123892: Current · expires 2028-10-31
- Trained
- University of Massachusetts Medical School, 2011
- Gender
- Female
More record details
- Sole proprietor
- Yes
- Taxonomy
- Plastic and reconstructive surgery (2086S0122X); Student in a training program (390200000X)
- Mailing address
- 513 Parnassus Ave, Department of Surgery S-321, San Francisco, CA, 94143
- NPI first listed
- 2011-03-28
- NPI last updated
- 2012-12-29
This is when the NPI record was last certified, not a medical board exam.