Individual provider Active NPI

Kelsey Suzanne Dyer, PA

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1043931728
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61614 Issued in CA
Practice address
3020 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 966-8800
NPI assigned
Sep 9, 2022
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61614 CA Primary

Addresses

Primary practice location

3020 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5003
San Diego, CA 92123-4223
Phone (858) 309-6300

Other practice location 1

25500 Medical Center Dr
Murrieta, CA 92562-5965
Phone (951) 696-6124

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251104001729 CA Practitioner - Physician Assistant 3971974239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians
Somagen Healthcare IncGroup PAC ID 1557530151, 53 clinicians

Practice addresses (Care Compare)

3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212

5671 Balboa Ave
San Diego, CA 92111-2705
Phone (858) 800-2880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61614CAMDPharmacist
PA61614CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Somagen Healthcare Inc CurrentSince Oct 27, 2025 Accepting new patients
Monica Perlman MD Inc. CurrentSince Nov 1, 2025 Accepting new patients
Somagen Healthcare Inc Current Accepting new patients
Somagen Healthcare Inc CurrentSince Oct 27, 2025 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Sep 11, 2022 Accepting new patients

Locations

750 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 259-9462

760 Otay Lakes Rd
Chula Vista, CA 91910
Phone (619) 821-2300

16912 San Fernando Mission Blvd
Granada Hills, CA 91344
Phone (818) 488-6160

9850 Genesee Ave
Ste 320
La Jolla, CA 92037
Phone (858) 864-9800

1740 Rosecrans St
San Diego, CA 92106
Phone (619) 790-7800

3737 Moraga Ave
Ste B103
San Diego, CA 92117
Phone (858) 799-0855

3900 5th Ave
Ste 110
San Diego, CA 92103
Phone (619) 291-5474

5671 Balboa Ave
San Diego, CA 92111
Phone (855) 362-9773

8260 Mira Mesa Blvd
Ste A
San Diego, CA 92126
Phone (855) 362-9773

8590 Rio San Diego Dr
Ste 111
San Diego, CA 92108
Phone (619) 736-4600

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1043931728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25500 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925625965",
            "country_code": "US",
            "telephone_number": "951-696-6124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYER",
        "first_name": "KELSEY",
        "middle_name": "SUZANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.