Kevin Byrne, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA57039 Issued in CA

Practice address

2405 Shadelands Dr
Walnut Creek, CA 94598-2444

Phone

(925) 939-8585

Fax

(925) 933-2912

NPI assigned

Jul 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • Walnut Creek, CA
  • NPI 1972552990
  Medicare reassignment
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment
• SNF Wound Care

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1114393311
  Medicare reassignment
• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • Oakland, CA
  • NPI 1164175592
  NPD
• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • San Jose, CA
  • NPI 1245021401
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • San Francisco, CA
  • NPI 1457004897
  NPD (past)

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1306499272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-256-2107",
            "fax_number": "925-378-7947"
        },
        {
            "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",
            "fax_number": "925-933-2912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "KEVIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-19",
        "last_updated": "2021-12-28",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA57039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1425 S Main St",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945965318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vitaliya Buynevich
• Viktor Buzin, MPA, PA-C
• Cheyenne Byrd
• Kathleen Marie Byrne Crew, LCSW
• Bonnie Byrne
• Nicholas Patrick Byrne, MD
• C-Dental X-Ray, Inc
• C.O.P.E. Family Support Center
• C.P. Wong, D.D.S. & M.B. Wong, D.D.S., a PDC
• Bonnie Joan Cabasino, MS SPEECH PATHOLOGIS

• Surgical Physician Assistant in Walnut Creek, CA
• Providers in Walnut Creek, 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 Dec 28, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.