Individual provider Active NPI

Kathryn S. Morales, PA-C

  • Medical Physician Assistant
  • Lynwood, CA
National Provider Identifier
1801934385
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 14514 Issued in CA
Practice address
12124 Bullis Rd
Lynwood, CA 90262-5106
Phone
(562) 867-7999
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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 PA 14514 CA Primary

Addresses

Primary practice location

12124 Bullis Rd
Lynwood, CA 90262-5106

Mailing address

5650 Jillson St
Commerce, CA 90040-1482
Phone (323) 201-4516

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
I20141010000736 CA Practitioner - Physician Assistant 1456571629 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 14514CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JWCH Institute Inc CurrentSince Oct 17, 2022 Accepting new patients
JWCH Institute, Inc. CurrentSince Oct 17, 2022 Accepting new patients
R Srinivasan MD Inc Past Accepting new patients

Locations

5650 Jillson St
Commerce, CA 90040
Phone (213) 484-1186

12124 Bullis Rd
Lynwood, CA 90262

12360 Firestone Blvd
Norwalk, CA 90650
Phone (562) 281-0305

Interoperability endpoints

  • Direct secure messaging: pamorales@plmci-ca.direct.office.nextgen.com
  • Direct secure messaging: kathryn.moralesmd.p1@direct.jwch.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1801934385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 JILLSON ST",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401482",
            "telephone_number": "323-201-4516",
            "fax_number": "323-215-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12124 BULLIS RD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902625106",
            "telephone_number": "562-867-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "KATHRYN",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA 14514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.