Individual provider Active NPI

Kevin Atwood Kirschner

  • Ophthalmic Assistant
  • Corona, CA
National Provider Identifier
1629127436
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic AssistantTaxonomy code 156FX1101X
Practice address
750 S Lincoln Ave Ste 104 PMB 383
Corona, CA 92882-3136
Phone
(951) 735-6285
Fax
(951) 735-8239
NPI assigned
Jan 10, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Assistant 156FX1101X NU Primary

Addresses

Primary practice location

750 S Lincoln Ave Ste 104 PMB 383
Corona, CA 92882-3136

Mailing address

750 S Lincoln Ave Ste 104 PMB 383
Corona, CA 92882-3136
Phone (951) 735-6285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070620000456 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9931208790 Practice locations: Corona, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gary S Reiter, MD Past Accepting new patients
Sidney Jay Weiss, M.D. Inc PastSince Feb 14, 2005 Accepting new patients
Efraim Duzman M.D., Inc PastSince Dec 9, 2010 Accepting new patients
Barbara Shang M D Inc Past Accepting new patients
Douglas Marsall Engh, M.D., F.a.C.S., Inc. PastSince Jun 2, 2008 Accepting new patients
Restorative Performance Physical Therapy, Professional Corporation PastSince Dec 31, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, 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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629127436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 S LINCOLN AVE STE 104 PMB 383",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823136",
            "telephone_number": "951-735-6285",
            "fax_number": "951-735-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 S LINCOLN AVE STE 104 PMB 383",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823136",
            "telephone_number": "951-735-6285",
            "fax_number": "951-735-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHNER",
        "first_name": "KEVIN",
        "middle_name": "ATWOOD",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1101X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.