Individual provider Active NPI

Kristen Anais Mikhail, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1205261179
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA57481 Issued in CA
Practice address
8635 W 3Rd St Ste 770
Los Angeles, CA 90048-6108
Phone
(424) 314-0224
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA57481 CA Primary

Addresses

Primary practice location

8635 W 3Rd St Ste 770
Los Angeles, CA 90048-6108

Mailing address

8635 W 3Rd St Ste 650
Los Angeles, CA 90048-6101
Phone (424) 314-0224

Other names 1

  • Kristen Iaconelli Former 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
I20231016001664 CA Practitioner - Physician Assistant 6709013154 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical CenterGroup PAC ID 0446169114, 788 clinicians

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.08 of 100Reported as group
Quality
64.86
Promoting interoperability
100
Improvement activities
40
Cost
46.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA57481CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Aug 4, 2025 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Aug 4, 2025 Accepting new patients

Locations

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

8635 W 3rd St
Ste 770
West Hollywood, CA 90048
Phone (310) 423-8350

Interoperability endpoints

  • Direct secure messaging: kmikhail524539@direct.cshs.org
  • Direct secure messaging: kmikhail1224501@direct.uclahealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1205261179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 650",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "424-314-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 770",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486108",
            "telephone_number": "424-314-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAIL",
        "first_name": "KRISTEN",
        "middle_name": "ANAIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA57481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "IACONELLI",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.