Individual provider Active NPI

Kristen Mohr

  • Medical Physician Assistant
  • San Diego, CA
National Provider Identifier
1659853901
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA55926 Issued in CA
Practice address
7625 Mesa College Dr
San Diego, CA 92111-5343
Phone
(858) 223-2172
NPI assigned
Sep 4, 2018
Last updated
Dec 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA55926 CA Primary

Addresses

Primary practice location

7625 Mesa College Dr
San Diego, CA 92111-5343

Mailing address

7625 Mesa College Dr
San Diego, CA 92111-5343

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
I20181109002683 CA Practitioner - Physician Assistant 8628322641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Decker DO, Inc.Group PAC ID 9830481746, 23 clinicians

Practice addresses (Care Compare)

2725 E Broadway
Long Beach, CA 90803-5431
Phone (949) 371-9773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.61 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
65.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55926CAMDPharmacist
PA55926CAMDMedical Physician Assistant

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1659853901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 MESA COLLEGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 MESA COLLEGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115343",
            "telephone_number": "858-223-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHR",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA55926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.