Individual provider Active NPI

Krystal S McCain, PA

  • Physician Assistant
  • Modesto, CA
National Provider Identifier
1750884391
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
62527 Issued in CA
Practice address
1114 6TH St
Modesto, CA 95354-2203
Phone
(209) 576-2845
Fax
(209) 576-8842
NPI assigned
Mar 9, 2018
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.1331 AL
Physician Assistant 363A00000X 62527 CA Primary

Addresses

Primary practice location

1114 6TH St
Modesto, CA 95354-2203

Mailing address

737 W Childs Ave
Merced, CA 95341-6805
Phone (209) 384-6481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180529003259 AL Practitioner - Physician Assistant 9234494980 Reassigns benefits to 3 organizations
I20231017001789 CA Practitioner - Physician Assistant 9234494980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Family Care, LLCGroup PAC ID 9739087818, 180 clinicians

Practice addresses (Care Compare)

20 Hazelwood Dr
Pell City, AL 35125-3382
Phone (205) 338-8008

30 Holmes Dr
Oxford, AL 36203-2420
Phone (256) 403-3534

366 E Meighan Blvd
Gadsden, AL 35903-1049
Phone (256) 485-0982

8151 Whitesburg Dr SE
Huntsville, AL 35802-4557
Phone (256) 882-9711

Merit-based Incentive Payment System (MIPS)

Final score
70.43 of 100Reported as group
Quality
65.59
Improvement activities
40
Cost
64.54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62527CAMDPediatric Dentist
PA.1331ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care, LLC CurrentSince Oct 30, 2020 Accepting new patients
United Indian Health Services, Inc. CurrentSince Nov 30, 2024 Accepting new patients
American Family Care, LLC CurrentSince Oct 30, 2020 Accepting new patients

Locations

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

1600 Weeot Way
Arcata, CA 95521
Phone (707) 825-5000

Organizations & group practices 7

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": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1750884391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 W CHILDS AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416805",
            "telephone_number": "209-384-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 6TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542203",
            "telephone_number": "209-576-2845",
            "fax_number": "209-576-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAIN",
        "first_name": "KRYSTAL",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1331",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "62527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.