Kathleen M. Nelson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13766 Issued in CA

Practice address

14711 Princeton Ave
Suite 2
Moorpark, CA 93021-1457

Phone

(805) 532-2032

Fax

(805) 532-2844

NPI assigned

Nov 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

73.77 of 100Reported as group

Quality

31.85

Promoting interoperability

98

Improvement activities

40

Cost

82.39

Merit-based Incentive Payment System (MIPS)

Final score

84.94 of 100Reported as group

Quality

73.38

Improvement activities

40

Cost

72.82

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1326229162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14711 PRINCETON AVE",
            "address_2": "SUITE 2",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211457",
            "telephone_number": "805-532-2032",
            "fax_number": "805-532-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14711 PRINCETON AVE",
            "address_2": "SUITE 2",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211457",
            "telephone_number": "805-532-2032",
            "fax_number": "805-532-2844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Loma Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930033100",
            "country_code": "US",
            "telephone_number": "805-641-6415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "13766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Muccia
• Astrid Carolina Munoz
• Madison Samantha Murachver
• Jeanette Nagai, MA CCC SLP
• Shauna Neally-Sportato, LVN
• Sendy Nguyen, PA-C
• Tina Thuy Tran Nguyen, D.D.S
• Jessica Sahar Nouhavandi, PHARMD
• Ardalan Alen Nourian, MD
• Ali A Novin-Baheran, RPH

• Physician Assistant in Moorpark, CA
• Providers in Moorpark, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.