Individual provider Active NPI

Kristina Lepard, PA-C

  • Physician Assistant
  • Vista, CA
National Provider Identifier
1053020362
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61577 Issued in CA
Practice address
204 S Santa Fe Ave
Vista, CA 92084-6002
Phone
(760) 941-8888
NPI assigned
Nov 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA61577 CA
Physician Assistant 363A00000X PA61577 CA Primary

Addresses

Primary practice location

204 S Santa Fe Ave
Vista, CA 92084-6002

Mailing address

204 S Santa Fe Ave
Vista, CA 92084-6002
Phone (760) 941-8888

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Epic

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
I20221205001687 CA Practitioner - Physician Assistant 3072982552 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

1040 Carlsbad Village Dr
Suite 106
Carlsbad, CA 92008-1981
Phone (442) 427-2474

204 S Santa Fe Ave
Vista, CA 92084-6002
Phone (858) 554-1212

314 S Twin Oaks Valley Rd
Suite 114
San Marcos, CA 92078-4390
Phone (442) 372-2330

3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855

6386 Alvarado CT
Suite 101
San Diego, CA 92120-4906
Phone (858) 900-9490

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61577CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Past Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1053020362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 S SANTA FE AVE",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920846002",
            "telephone_number": "760-941-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S SANTA FE AVE",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920846002",
            "telephone_number": "760-941-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPARD",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA61577",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "address_1": "204 S Santa Fe Ave",
            "city": "Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920846002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.