Kelsey Renee Abrahamsen, PA-C
Individual provider Active NPI Medical Physician Assistant · La Jolla, CA
NPI 1396255477 · NPPES record last updated Jun 29, 2022
Key facts
- NPI
- 1396255477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 55679 (CA)
- Practice address
- 9850 Genesee Ave Ste 320
La Jolla, CA 92037 - Phone
- (858) 554-1212
- NPI assigned
- Oct 3, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Monica Perlman MD Inc
Practice addresses (Care Compare)
3180 University Ave
Suite 120
San Diego, CA 92104-2046
Phone (858) 554-1212
3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855
3900 5TH Ave
Suite 110
San Diego, CA 92103-3122
Phone (858) 554-1212
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.17 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190520000462 | CA | Practitioner - Physician Assistant | 7810254968 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Past | Accepting new patients | |
| UC San Diego Health - Rancho Family Medical Group | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- kbrangoccio@wsfp.gwaydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 55679 | CA | Yes |
Addresses
Primary practice location
9850 Genesee Ave Ste 320
La Jolla, CA 92037
Mailing address
9850 Genesee Ave Ste 320
La Jolla, CA 92037-1208
Phone (858) 554-1212
Other names
- Kelsey Renee Brangoccio
Other providers in La Jolla, CA
- Richard R. Abello
- Oyewale Oyedeji Abidoye
- Ability Rehabilitation Specialists
- Maria Cecily Abraham
- Mickey Ellis Abraham
- Darryl Abramson
- Amanda Abrisch
- Nadia Elizabeth Bassam Abu-Douleh
- Edsel Misael Abud
- Sami Abujbarah
All providers in La Jolla, CA · Medical Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.