Individual provider Active NPI

Keerstin Nicole Beitter, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1477129302
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3434 Midway Dr Ste 2001
San Diego, CA 92110-4924
Phone
(619) 325-1161
NPI assigned
Jun 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3434 Midway Dr Ste 2001
San Diego, CA 92110-4924

Mailing address

3434 Midway Dr Ste 2004
San Diego, CA 92110-4925
Phone (619) 325-1161

Other practice location 1

3900 Fifth Ave Ste 110
San Diego, CA 92103-3122
Phone (858) 554-1212

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211006002838 CA Practitioner - Physician Assistant 9830597707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

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
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59691CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Algos Inc., a Medical Corporation CurrentSince Aug 30, 2021 Accepting new patients
Synergy Orthopedic Specialists, Inc. CurrentSince Apr 22, 2024 Accepting new patients
Synergy Orthopedic Specialists, Inc. CurrentSince Apr 22, 2024 Accepting new patients
Algos Inc., a Medical Corporation CurrentSince Aug 30, 2021 Accepting new patients
Algos Inc., a Medical Corporation PastSince Dec 12, 2021 Accepting new patients

Locations

88 E Bonita Rd
Ste C
Chula Vista, CA 91910
Phone (619) 230-0855

891 Kuhn Dr
Ste 106
Chula Vista, CA 91914
Phone (619) 761-5308

1017 S Fair Oaks Ave
Pasadena, CA 91105
Phone (626) 403-6200

7525 Metropolitan Dr
Ste 302
San Diego, CA 92108
Phone (619) 325-1161

4445 Eastgate Mall
Ste 105
San Diego, CA 92121
Phone (858) 357-9450

3750 Convoy St
Ste 201
San Diego, CA 92111
Phone (858) 278-8031

3434 Midway Dr
Ste 2001
San Diego, CA 92110
Phone (619) 226-8871

4445 Eastgate Mall
Ste 103
San Diego, CA 92121
Phone (858) 450-7118

9095 Rio San Diego Dr
Ste 450
San Diego, CA 92108
Phone (619) 853-8860

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1477129302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 MIDWAY DR STE 2004",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104925",
            "telephone_number": "619-325-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 MIDWAY DR STE 2001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104924",
            "telephone_number": "619-325-1161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Fifth Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921033122",
            "country_code": "US",
            "telephone_number": "858-554-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEITTER",
        "first_name": "KEERSTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.