Individual provider Active NPI

Alan Lloyd Kearns, PA

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1619128634
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60680701 Issued in WA
Practice address
402 S 4TH Ave
Yakima, WA 98902-3546
Phone
(509) 575-4084
NPI assigned
Oct 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60680701 WA Primary
Mental Health Counselor 101YM0800X SC60113634 WA
Mental Health Counselor 101YM0800X LW60296750 WA

Addresses

Primary practice location

402 S 4TH Ave
Yakima, WA 98902-3546

Mailing address

402 S 4TH Ave
Yakima, WA 98902-3546
Phone (509) 575-4084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20170222002302 WA Practitioner - Physician Assistant 9436433240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive HealthcareGroup PAC ID 7618875022, 32 clinicians

Practice addresses (Care Compare)

402 S 4TH Ave
Yakima, WA 98902-3546
Phone (509) 575-4084

707 N Pearl St
Suite E
Ellensburg, WA 98926-2938
Phone (509) 925-7507

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LW60296750WAMDMental Health Counselor
SC60113634WAMDMental Health Counselor
PA60680701WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare CurrentSince Jan 18, 2017 Accepting new patients

Locations

402 S 4th Ave
Yakima, WA 98902
Phone (509) 575-3874

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1619128634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023546",
            "telephone_number": "509-575-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023546",
            "telephone_number": "509-575-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNS",
        "first_name": "ALAN",
        "middle_name": "LLOYD",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-08",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60680701",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "SC60113634",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LW60296750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.