Active NPI
Stephanie Kirk, PA-C
- Physician Assistant
- Menifee, CA
National Provider Identifier
1013314442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA52048
- Practice address
- 29826 Haun Rd
Suite 302
Menifee, CA 92586-6546 - Phone
- (951) 672-1911
- Fax
- (951) 672-8406
- NPI assigned
- Dec 1, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA52048 | CA | Primary |
Addresses
Primary practice location
29826 Haun Rd
Suite 302
Menifee, CA 92586-6546
Mailing address
29826 Haun Rd
Suite 302
Menifee, CA 92586-6546
Phone (951) 672-1911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
29826 Haun Rd
Suite 302
Menifee, CA 92586-6547
Phone (951) 672-1911
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52048 | CA | MD | Dentist |
| PA52048 | CA | MD | Physician Assistant |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJJJAA/Endpoint/JJJJAA
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Menifee, CA
- NPI 1386301687
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417392000000",
"number": "1013314442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29826 HAUN RD",
"address_2": "SUITE 302",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925866546",
"telephone_number": "951-672-1911",
"fax_number": "951-672-8406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29826 HAUN RD",
"address_2": "SUITE 302",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925866546",
"telephone_number": "951-672-1911",
"fax_number": "951-672-8406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "STEPHANIE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-01",
"last_updated": "2014-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA52048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menifee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.