Kristen Dean, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9115509 Issued in FL

Practice address

992 Brinkley CT
Fort Walton Beach, FL 32547-1823

Phone

(970) 397-8485

NPI assigned

Mar 22, 2022

Last updated

Mar 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, NJ, NH, VA4 enrollments

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 4

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Services of NH, LLCGroup PAC ID 3173988474, 66 clinicians

Emergency Medicine Services of VA LLCGroup PAC ID 6103291430, 38 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Services of NH, LLC

  • Emergency Medicine Physician
  • Derry, NH
  • NPI 1386341444
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Services of VA, LLC

  • Emergency Medicine Physician
  • Fredericksburg, VA
  • NPI 1992402069
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• Florida Em-I Medical Services, PA

  • Nurse Practitioner
  • Fort Lauderdale, FL
  • NPI 1316764988
  Medicare reassignment
• Santa Rosa HB Medical Services LLC

  • Emergency Medicine Physician
  • Milton, FL
  • NPI 1982384988
  Medicare reassignment
• New Jersey/Pennsylvania Em-I Medical Services, P.C.

  • Emergency Medicine Physician
  • Paramus, NJ
  • NPI 1851616544
  Medicare reassignment
• Florida Em-I Medical Services, PA

  • Nurse Practitioner
  • Coral Springs, FL
  • NPI 1336966910

  Physician Assistant

  NPD

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1316696685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 BRINKLEY CT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471823",
            "telephone_number": "970-397-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 BRINKLEY CT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471823",
            "telephone_number": "970-397-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "KRISTEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9115509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE",
            "identifier": "PA9115509",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "address_1": "992 Brinkley Ct",
            "city": "Fort Walton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325471823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeanie Sadler Dawson, LPN
• Andrew De Cotis, FNP-C
• Margherita Graziosa De Moya, DDS
• Victor De Moya, M.D.
• David Joseph Dean, D.O.
• Rodrick Heath Deason, D.M.D.
• Diana Marie Decotis Smith, M.D.
• Anthony Decotis, M.D.
• Francis C.F. Decroos, MD
• Erica Dees

• Physician Assistant in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.