Active NPI
Kay Dee Roberts, PA
- Medical Physician Assistant
- Palmdale, CA
National Provider Identifier
1508057316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA011543
- Practice address
- 41230 11TH St W Ste E
Palmdale, CA 93551-1411 - Phone
- (661) 273-1614
- Fax
- (661) 273-4816
- NPI assigned
- Aug 6, 2007
- Last updated
- Jul 7, 2016
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA011543 | CA | Primary |
Addresses
Primary practice location
41230 11TH St W Ste E
Palmdale, CA 93551-1411
Mailing address
38460 5TH St W
Palmdale, CA 93551-4685
Phone (661) 273-1614
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA011543 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lancaster Hospital Corporation | Past | Accepting new patients | |
| Bakersfield Memorial Hospital | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- kay.roberts.1@23708.direct.athenahealth.com
Organizations & group practices 3
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.
-
dba Joshua medical group
- Family Medicine Physician
- Palmdale, CA
- NPI 1205023249
-
dba Bakersfield Memorial Hospital Pharmacy
- Institutional Pharmacy
- Bakersfield, CA
- NPI 1144256363
-
dba Palmdale Regional Medical Center
- Rehabilitation Hospital Unit
- Palmdale, CA
- NPI 1033109947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467849600000",
"number": "1508057316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38460 5TH ST W",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935514685",
"telephone_number": "661-273-1614",
"fax_number": "661-273-4816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41230 11TH ST W STE E",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935511411",
"telephone_number": "661-273-1614",
"fax_number": "661-273-4816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KAY",
"middle_name": "DEE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-06",
"last_updated": "2016-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA011543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.