Kari Lynn Provost, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA22507 Issued in CA

Practice address

12595 Hesperia Rd Ste 101
Victorville, CA 92395

Phone

(760) 881-3377

Fax

(760) 881-3379

NPI assigned

Sep 4, 2012

Last updated

Jul 30, 2018By the provider in NPPES

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

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

92.83

Promoting interoperability

100

Improvement activities

40

Cost

78.22

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• The Gastro Group, Inc.

  • Gastroenterology Physician
  • Victorville, CA
  • NPI 1316247521
  Medicare reassignment
• Diamond Pathology LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Victorville, CA
  • NPI 1558186650
  NPD
• Victor Valley Community Hospital

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1952311953
  NPD (past)

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1376892521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12595 HESPERIA RD STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955882",
            "telephone_number": "760-881-3377",
            "fax_number": "760-881-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12595 HESPERIA RD STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92395",
            "telephone_number": "760-881-3377",
            "fax_number": "760-881-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "KARI",
        "middle_name": "LYNN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priority One Medical Transit
• Pro Line Transportation LLC
• Procare Dental - Victorville
• Procare Dental Group, Joey S. Tirador D.D.S. Inc.
• Provident Place
• Maxine Pryor
• Public in-Home Support Services Authority
• Kimberly Pukal
• Sheree Pulliam, MFT
• Purevision Optometry

• Medical Physician Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.