Individual provider Active NPI

Kelsey Marlene Hults, PA

  • Surgical Physician Assistant
  • Walnut Creek, CA
National Provider Identifier
1225702525
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
60319 Issued in CA
Practice address
2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Phone
(925) 939-8585
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X 60319 CA Primary

Addresses

Primary practice location

2405 Shadelands Dr
Walnut Creek, CA 94598-2444

Mailing address

PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585

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
I20211203001160 CA Practitioner - Physician Assistant 1759771835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 Sand Creek Rd
Suite a
Brentwood, CA 94513-2539
Phone (925) 939-8585

101 Sand Creek Rd
Suite B
Brentwood, CA 94513-2540
Phone (925) 939-8585

2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Phone (925) 939-8585

350 John Muir Pkwy
Suite 155
Brentwood, CA 94513-5190
Phone (925) 939-8585

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine Multi-Specialty CurrentSince Nov 29, 2021 Accepting new patients
Golden State Orthopedics & Spine Multi-Specialty CurrentSince Nov 29, 2021 Accepting new patients
Golden State Orthopedics & Spine Multi-Specialty Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients
Golden State Orthopedics & Spine Multi-Specialty Past Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients
Sutter Delta Medical Center Past Accepting new patients

Locations

350 John Muir Pkwy
Ste 155
Brentwood, CA 94513

5201 Norris Canyon Rd
Ste 230
San Ramon, CA 94583
Phone (925) 244-9355

2405 Shadelands Dr
Ste 300
Walnut Creek, CA 94598

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

Interoperability endpoints

  • Direct secure messaging: kelsey.hults.p1@direct.muirortho.nextgenshare.com

Organizations & group practices 8

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": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1225702525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982444",
            "telephone_number": "925-939-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTS",
        "first_name": "KELSEY",
        "middle_name": "MARLENE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "60319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

Verify at the official NPI Registry.