Kevin Jude Holman, PA-C
Individual provider Active NPI Physician Assistant · Novato, CA
NPI 1770849671 · NPPES record last updated Apr 4, 2012
Key facts
- NPI
- 1770849671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 19270 (CA)
- Practice address
- 7100 Redwood Blvd
Suite 200
Novato, CA 94945-4110 - Phone
- (415) 492-1600
- Fax
- (415) 492-1688
- NPI assigned
- Apr 4, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Sutter Bay Medical Foundation
Practice addresses (Care Compare)
101 Rowland Way
Novato, CA 94945-5056
795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020
Hospital & facility affiliations
- Novato Community Hospital
- Marinhealth Medical Center
- Sonoma Valley Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161110002240 | CA | Practitioner - Physician Assistant | 8820377047 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Orthopedics & Spine Inc | Current |
Accepting new patients | |
| Sutter Bay Medical Foundation | Current |
Accepting new patients | |
| Sutter Bay Medical Foundation | Current |
Accepting new patients | |
| Sutter East Bay Medical Foundation | Past | Accepting new patients |
Locations
18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590
1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100
3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800
1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777
18 Bon Air Rd
Larkspur, CA 94939
Phone (415) 927-5300
2 Bon Air Rd
Ste 120
Larkspur, CA 94939
Phone (415) 496-2812
370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200
325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200
7100 Redwood Blvd
Ste 200
Novato, CA 94945
Phone (415) 492-1600
795 El Camino Real
#1112
Palo Alto, CA 94301
795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832
1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911
151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505
3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847
123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200
3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750
10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488
550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865
Interoperability endpoints
- kholman224725@hisp.ehr.sutterhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 19270 | CA | Yes |
Addresses
Primary practice location
7100 Redwood Blvd
Suite 200
Novato, CA 94945-4110
Mailing address
7100 Redwood Blvd
Suite 200
Novato, CA 94945-4110
Phone (415) 492-1600
Other providers in Novato, CA
- Elise Holland
- Brian Neal Hollander
- Susan Carol Hollander
- Jessica Catherine Hollman
- Holly C Kelly MD Inc.
- Donnell M Holmes
- Sara Mathew Holmes
- Homewatch Caregivers of the North Bay
- Honeycomb Wellness Center LLC
- Angela Marie Hopper
All providers in Novato, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.