Individual provider Active NPI

Kimberly Erin Esgate, PA

  • Medical Physician Assistant
  • Thousand Oaks, CA
National Provider Identifier
1174166714
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA58862 Issued in CA
Practice address
187 E Wilbur Rd Ste 100
Thousand Oaks, CA 91360-7925
Phone
(805) 492-1015
Fax
(805) 492-2035
NPI assigned
Oct 27, 2019
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA58862 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

187 E Wilbur Rd Ste 100
Thousand Oaks, CA 91360-7925

Mailing address

1970 Rory LN Unit 2
Simi Valley, CA 93063-4388
Phone (805) 875-7883

Other practice location 1

865 Patriot Dr
Moorpark, CA 93021-3407
Phone (661) 600-5196

Other practice location 2

1980 Sequoia Ave
Simi Valley, CA 93063-3167
Phone (805) 583-5555

Other names 1

  • Erin Esgate Other name

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
I20221104000634 CA Practitioner - Physician Assistant 4880061803 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58862CAMDPharmacist
PA58862CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Ventura Medical Group, Inc. Single Specialty Current Accepting new patients

Locations

1980 Sequoia Ave
Simi Valley, CA 93063
Phone (805) 527-1804

Interoperability endpoints

  • Direct secure messaging: kimberly.esgate.1@1492.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1174166714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 RORY LN UNIT 2",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930634388",
            "telephone_number": "805-875-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 E WILBUR RD STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913607925",
            "telephone_number": "805-492-1015",
            "fax_number": "805-492-2035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "865 Patriot Dr",
            "address_purpose": "LOCATION",
            "city": "Moorpark",
            "state": "CA",
            "postal_code": "930213407",
            "country_code": "US",
            "telephone_number": "661-600-5196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1980 Sequoia Ave",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930633167",
            "country_code": "US",
            "telephone_number": "805-583-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESGATE",
        "first_name": "KIMBERLY",
        "middle_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA58862",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "ESGATE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.