Kirsten Alyssa Stathes, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16025 Issued in CA

Practice address

350 Terracina Blvd
Redlands, CA 92373-4850

Phone

(909) 335-5500

Fax

(909) 335-6490

NPI assigned

Aug 31, 2006

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

Other names 1

• Kristen Alyssa Clark Former name

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

96.69 of 100Reported as group

Quality

90

Improvement activities

40

Cost

78.43

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 and National Provider Directory roles.

• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Redlands, CA
  • NPI 1619926771
  NPD
• Cep America - California

  • Emergency Medicine Physician
  • Colton, CA
  • NPI 1306899166
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1407968324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 TERRACINA BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734850",
            "telephone_number": "909-335-5500",
            "fax_number": "909-335-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHES",
        "first_name": "KIRSTEN",
        "middle_name": "ALYSSA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "CLARK",
            "middle_name": "ALYSSA",
            "credential": "P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jocelyne Aho Stancic
• Shantela Stanfield, FNP-BC
• Khushal Alam Stanisai, MD
• Diamond Sade Stanley
• Stately Urgent Care PC
• Eric Steele, M.D.
• Nadine Steele, LAADAC CA, CADCII-CA
• Jamalle P Steinmann, NP
• John C Steinmann, DO
• Thomas A. Steinmann, O.D.

• Physician Assistant in Redlands, CA
• Providers in Redlands, 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 4, 2009; 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.