Individual provider Active NPI

Kelly McGuire

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1063247153
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
65611 Issued in CA
Practice address
3900 Fifth Ave Ste 340
San Diego, CA 92103-3138
Phone
(582) 500-2868
NPI assigned
Sep 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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 65611 CA Primary

Addresses

Primary practice location

3900 Fifth Ave Ste 340
San Diego, CA 92103-3138

Mailing address

3900 Fifth Ave Ste 340
San Diego, CA 92103-3138
Phone (582) 500-2868

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
I20250116003555 CA Practitioner - Physician Assistant 9335677491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

3180 University Ave
Suite 120
San Diego, CA 92104-2046
Phone (858) 554-1212

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

4142 Adams Ave
Suite 102
San Diego, CA 92116-2593
Phone (858) 617-0717

4358 Bonita Rd
Suite 400
Bonita, CA 91902-1421
Phone 619695126645

477 N El Camino Real
Suite A200
Encinitas, CA 92024-1350
Phone (858) 766-6007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1725580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1063247153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 FIFTH AVE STE 340",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033138",
            "telephone_number": "582-500-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 FIFTH AVE STE 340",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033138",
            "telephone_number": "582-500-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-06",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.