Active NPI
Kyle Koch, PA-C
- Physician Assistant
- Redlands, CA
National Provider Identifier
1396611539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA67268
- Practice address
- 350 Terracina Blvd
Redlands, CA 92373-4897 - Phone
- (949) 636-6138
- NPI assigned
- Oct 15, 2025
- Last updated
- Jan 5, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA67268 | CA | Primary |
Addresses
Primary practice location
350 Terracina Blvd
Redlands, CA 92373-4897
Mailing address
26081 Los Cerros Dr
Laguna Hills, CA 92653-8204
Phone (949) 636-6138
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
350 Terracina Blvd
Redlands, CA 92373-4850
Phone (909) 335-5500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67268 | CA | MD | Massage Therapist |
| PA67268 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America-California | Current | Accepting new patients |
Locations
350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500
Organizations & group practices 2
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 Physician
- Murrieta, CA
- NPI 1588552848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767571200000",
"number": "1396611539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26081 LOS CERROS DR",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926538204",
"telephone_number": "949-636-6138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 TERRACINA BLVD",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734897",
"telephone_number": "949-636-6138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "KYLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-15",
"last_updated": "2026-01-05",
"certification_date": "2026-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA67268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.