Kyle Green, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

22431 Antonio Pkwy # B160-613
Rancho Santa Margarita, CA 92688-2804

Phone

(855) 727-2251

Fax

(855) 727-2251

NPI assigned

Jun 30, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Assistant Specialists-California IncGroup PAC ID 1355791997, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115
• Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgreen371326@direct.llu.edu
• Direct secure messaging: kyle.green.p1@direct.arch.nextgenshare.com

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.

• Physician Assistant Specialists-California Inc

  • Surgical Physician Assistant
  • Rancho Santa Margarita, CA
  • NPI 1245017185
  Medicare reassignment Care Compare group
• Arch Health Partners, Inc

  • Family Medicine Physician
  • Poway, CA
  • NPI 1649500141
  Medicare reassignment
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment
• Arch Health Partners

  • Family Medicine Physician
  • San Diego, CA
  • NPI 1568870657
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Redlands, CA
  • NPI 1235189911
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1275582918
  NPD (past)
• Healthcare Service Partners, Inc.

  • Surgical Physician Assistant
  • Rancho Santa Margarita, CA
  • NPI 1356889265
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Palomar Health

  • General Acute Care Hospital
  • Escondido, CA
  • NPI 1457321317
  Care Compare affiliation
• Pomona Valley Hospital Medical Center

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1407813660
  Care Compare affiliation

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1194246041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22431 ANTONIO PKWY # B160-613",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882804",
            "telephone_number": "855-727-2251",
            "fax_number": "855-727-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22431 ANTONIO PKWY # B160-613",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882804",
            "telephone_number": "855-727-2251",
            "fax_number": "855-727-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "58474",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn S Gore, MD
• Ashley Gormley
• Alexander Daniel Gorski, O.D
• Marsha Funderburk Granese, M.D.
• Kaelyn Elizabeth Green, MA OTR/L
• Kaitlyn Greene
• Greg J. Herd, a Dental Corp
• Sherri Gruszczynski, SLP
• Sandra Haider, DPM
• Emily Haley, ASW 124566

• Surgical Physician Assistant in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.