Kellie Morales, MSPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61013 Issued in CA

Practice address

204 E Beach St
Watsonville, CA 95076-4809

Phone

(831) 728-0222

NPI assigned

Jun 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kellie McDonald Former name

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

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.

• Juniper Healthcare

  • Adult Medicine Physician
  • Redding, CA
  • NPI 1225875123
  Medicare reassignment
• Salud Para la Gente

  • Federally Qualified Health Center (FQHC)
  • Salinas, CA
  • NPI 1497012561
  NPD
• Salud Para la Gente

  • Federally Qualified Health Center (FQHC)
  • Seaside, CA
  • NPI 1700142544
  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093385213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E BEACH ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764809",
            "telephone_number": "831-728-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E BEACH ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950764809",
            "telephone_number": "831-728-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "KELLIE",
        "credential": "MSPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2023-03-07",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT BOARD",
            "identifier": "PA61013",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "MCDONALD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claudia Montero
• Sandra Carmen Montes- Perez, ACSW
• Corina Nicole Montes
• Paige Lee Moore, M.D.
• Taylor Mackenzie Moore
• Ariel Morell Planes, FNP-C
• Karina Moreno
• Sandra Morgan, REGISTERED NURSE
• Carlos Alexander Morillo-Hernandez, MD
• Michelle R. Moses, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.