Kevin A Kissoon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1377 Dresden Dr NE
Brookhaven, GA 30319-3400

Phone

(407) 620-2007

NPI assigned

Sep 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL2 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 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Guidewell Emergency Medicine Doctors, LLCGroup PAC ID 8224352919, 88 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Guidewell Emergency Medicine Doctors, LLC

  • Urgent Care Clinic/Center
  • Winter Park, FL
  • NPI 1629497235

  FL

  Medicare reassignment Care Compare group NPD
• Georgia Emergency Group, LLC

  • Emergency Medicine Physician
  • Griffin, GA
  • NPI 1952746638

  GA

  Medicare reassignment
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180

  FL

  Medicare reassignment
• Guidewell Emergency Medicine Doctors, LLC

  • Radiology Clinic/Center
  • Winter Park, FL
  • NPI 1639973555
  NPD (past)

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1124796289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 DRESDEN DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193400",
            "telephone_number": "407-620-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 DRESDEN DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193400",
            "telephone_number": "407-620-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSOON",
        "first_name": "KEVIN",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Kim
• Jasmine Nicole Kincaid, LPC
• Kayla Renae King, RBT
• James Kingman, M.S.
• Susan Kirsch, M.D.
• Sonya Lynne Klein, MSN, APRN, PMHNP-BC
• Katherine Dru Klinger
• Samantha Knight, DMD
• Gayle Kornman, O.D.
• Karyn Korsah

• Physician Assistant in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.