Kristy Elaine Matschullat, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64279 Issued in CA

Practice address

1780 E Bullard Ave
Fresno, CA 93710-5861

Phone

(800) 492-4227

Fax

(559) 646-3652

NPI assigned

Apr 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, CO, NV, CA, NM5 enrollments

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 5

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vituity Physician Services PCGroup PAC ID 0749620888, 58 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.41 of 100Reported as group

Quality

86.81

Improvement activities

40

Cost

77.34

Merit-based Incentive Payment System (MIPS)

Final score

85.48 of 100Reported as group

Quality

80.12

Promoting interoperability

100

Improvement activities

40

Cost

71.46

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Vituity Physician Services PC

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1124884176

  CA

  Medicare reassignment Care Compare group NPD
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583

  CA

  Medicare reassignment NPD
• El Camino Health Medical Network, LLC

  • Multi-Specialty Clinic/Center
  • San Jose, CA
  • NPI 1164880761

  CA

  Medicare reassignment
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110

  IL

  Medicare reassignment
• Colorado Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Arvada, CO
  • NPI 1144251976

  CO

  Medicare reassignment
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elk Grove Village, IL
  • NPI 1528681822
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD
• Colorado Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Greeley, CO
  • NPI 1447868880
  NPD
• Colorado Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Thornton, CO
  • NPI 1831707272
  NPD
• Colorado Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Golden, CO
  • NPI 1831707447
  NPD
• El Camino Health Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Los Gatos, CA
  • NPI 1578831764
  NPD (past)

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1063702116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL SREET SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 E BULLARD AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105861",
            "telephone_number": "800-492-4227",
            "fax_number": "559-646-3652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 N Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601232300",
            "country_code": "US",
            "telephone_number": "847-742-9800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17121 S Golden Rd Ste C150",
            "address_purpose": "LOCATION",
            "city": "Golden",
            "state": "CO",
            "postal_code": "804017301",
            "country_code": "US",
            "telephone_number": "720-506-1332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATSCHULLAT",
        "first_name": "KRISTY",
        "middle_name": "ELAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2026-0048",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64279",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0604",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003971",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Nduku Mativo, RDN
• Pamela Joyce Matlock, RDH
• Alyssa Matoba
• Samantha Matossian
• Matsam Medical Group, Inc.
• Esterlina Batistil Matson, LVN
• Greg N. Matsubara, MD
• Mimi Matsumoto, PHARM.D.
• Shari Matsuura, PT
• Olivia Matsuyama

• Physician Assistant in Fresno, CA
• Providers in Fresno, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.

Verify at the official NPI Registry.