Kevin Stuessy

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA13836 Issued in TX

Practice address

221 3Rd St W BLDG 1040
Jbsa Randolph, TX 78150-4800

Phone

(210) 652-0304

NPI assigned

Apr 3, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

University of Nebraska College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bristol Bay Area Health CorporationGroup PAC ID 5890699920, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bristol Bay Dba Kanakanak Hospital Hospital, Dillingham, AK, CCN 021309

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Aleknagik North, AK
  • NPI 1235291246

  Multi-Specialty, TX

  Medicare reassignment Care Compare group NPD
• Doctors on Duty Medical Group, Inc

  • Urgent Care Clinic/Center
  • Salinas, CA
  • NPI 1568465466
  Medicare reassignment
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Koliganek, AK
  • NPI 1013079607

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Ekwok, AK
  • NPI 1104988799

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Pilot Point, AK
  • NPI 1174683825

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Platinum, AK
  • NPI 1285796870

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Levelock, AK
  • NPI 1366502767

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • South Naknek, AK
  • NPI 1417018193

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Twin Hills, AK
  • NPI 1487716825

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Perryville, AK
  • NPI 1528128782

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Chignik Lagoon, AK
  • NPI 1578623641

  Multi-Specialty

  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Egegik, AK
  • NPI 1699836007

  Multi-Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Togiak, AK
  • NPI 1093877680

  Hospital

  Care Compare affiliation
• Bristol Bay Area Health Corporation

  • Critical Access Hospital
  • Dillingham, AK
  • NPI 1831270842
  Care Compare affiliation
• Bristol Bay Area Health Corporation

  • Critical Access Hospital
  • Dillingham, AK
  • NPI 1962688309
  Care Compare affiliation

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1437577632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "JBSA RANDOLPH",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-0304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-2520",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "443 Chaplian Madsig Ave",
            "address_purpose": "LOCATION",
            "city": "Presidio of Monterey",
            "state": "CA",
            "postal_code": "93940",
            "country_code": "US",
            "telephone_number": "831-242-7528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUESSY",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "55719",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA13836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Schlain, MD
• Stephanie Marie Smith, LCSW
• Lashika Deshaun Sneed, M.D.
• Pandu Ranga Sridhar, MD
• Jennifer Ann Stangle, MD
• Voncile Deann Stutts, RN
• Alexandra Loan Huynh Tran, O.D.
• Robert Paul Vanhoy, DO
• Kasey Carl Welch, D.O.
• Erica L. Wood, PHARMD

• Medical Physician Assistant in Jbsa Randolph, TX
• Providers in Jbsa Randolph, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.