Individual provider Active NPI

Kyle Oscarson, PA-C

  • Physician Assistant
  • Moreno Valley, CA
National Provider Identifier
1285407742
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63353 Issued in CA
Practice address
27300 Iris Ave
Moreno Valley, CA 92555-4802
Phone
(951) 243-2018
NPI assigned
Nov 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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 63353 CA Primary

Addresses

Primary practice location

27300 Iris Ave
Moreno Valley, CA 92555-4802

Mailing address

6285 E Spring St
Long Beach, CA 90808-4020

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
I20240117004687 CA Practitioner - Physician Assistant 8426400177 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63353CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Dec 8, 2023 Accepting new patients
Cep America-California CurrentSince Dec 8, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

27300 Iris Ave
Moreno Valley, CA 92555
Phone (909) 243-0811

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1285407742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6285 E SPRING ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908084020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27300 IRIS AVE",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554802",
            "telephone_number": "951-243-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSCARSON",
        "first_name": "KYLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.