NPIMap

Organization Active NPI

Pathways Community Services LLC

Doing business as Kickstart

  • Community/Behavioral Health Agency
  • San Diego, CA
National Provider Identifier
1104247659
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PATHWAYS COMMUNITY SERVICES LLC
Doing business as
Kickstart
Practice address
6160 Mission Gorge Rd Ste 100
San Diego, CA 92120-3425
Phone
(619) 481-3790
Fax
(619) 481-3797
NPI assigned
Dec 31, 2013
Last updated
Jul 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Tracy Ginter, MBA, CBCS
Title
Director of State Operations
Phone
(657) 465-9497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

6160 Mission Gorge Rd Ste 100
San Diego, CA 92120-3425

Mailing address

8337 Telegraph Rd Ste 300
Pico Rivera, CA 90660-4957
Phone (562) 467-5440

Other practice location 1

6160 Mission Gorge Rd
Suite 100
San Diego, CA 92120-3410
Phone (619) 491-3790

Other names 1

  • Kickstart Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110811000525 CA Part B Supplier - Clinic/Group Practice 9830368687 Receives reassigned benefits from 27 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pico Rivera, CA; Tustin, CA; Santa Ana, CA; San Diego, CA; Lancaster, CA; Garden Grove, CA; Anaheim, CA

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pathways Community Serivces LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1104247659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8337 TELEGRAPH RD STE 300",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604957",
            "telephone_number": "562-467-5440",
            "fax_number": "562-467-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 MISSION GORGE RD STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203425",
            "telephone_number": "619-481-3790",
            "fax_number": "619-481-3797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6160 Mission Gorge Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921203410",
            "country_code": "US",
            "telephone_number": "619-491-3790",
            "fax_number": "619-481-3797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATHWAYS COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-31",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "GINTER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR OF STATE OPERATIONS",
        "authorized_official_telephone_number": "657-465-9497",
        "authorized_official_credential": "MBA, CBCS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kickstart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.