Individual provider Active NPI

Kelsey Ann Masterson, PA-C

  • Physician Assistant
  • Palm Springs, FL
National Provider Identifier
1821531070
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111251 Issued in FL
Practice address
1630 S Congress Ave Ste 200
Palm Springs, FL 33461-2171
Phone
(561) 253-3980
Fax
(561) 253-3985
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9111251 FL Primary
Physician Assistant 363A00000X 23.003728 CT
Medical Physician Assistant 363AM0700X PA9111251 FL

Addresses

Primary practice location

1630 S Congress Ave Ste 200
Palm Springs, FL 33461-2171

Mailing address

PO Box 160748
Altamonte Springs, FL 32716-0748
Phone (561) 253-3980

Other practice location 1

11621 Kew Gardens Ave Ste 101A
Palm Beach Gardens, FL 33410-2853
Phone (561) 253-3980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181228000779 FL Practitioner - Physician Assistant 1759662737 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cancer Center of South Florida PLLCGroup PAC ID 8426120239, 47 clinicians

Practice addresses (Care Compare)

11621 Kew Gardens Ave
Suite 101a
Palm Beach Gardens, FL 33410-2853
Phone (561) 253-3980

1210 S Old Dixie Hwy
Jupiter Medical Center
Jupiter, FL 33458-7205
Phone (561) 253-3980

1309 N Flagler Dr
Good Samaritan Medical Center
West Palm Beach, FL 33401-3406
Phone (561) 655-5511

5301 S Congress Ave
JFK Medical Center
Atlantis, FL 33462-1149
Phone (561) 253-3980

Hospital & facility affiliations

  • Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253
  • HCA Florida JFK Hospital Hospital, Atlantis, FL, CCN 100080
  • Palm Beach Gardens Medical Center Hospital, Palm Beach Gardens, FL, CCN 100176
  • Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23.003728CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Cancer Center of South Florida PLLC CurrentSince May 6, 2024 Accepting new patients
Bridgeport Hospital CurrentSince Dec 1, 2016 Accepting new patients

Locations

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

11621 Kew Gardens Ave
Ste 101A
Palm Beach Gardens, FL 33410
Phone (561) 832-1234

1630 S Congress Ave
Ste 200
Palm Springs, FL 33461
Phone (561) 621-0012

1309 N Flagler Dr
West Palm Beach, FL 33401
Phone (561) 650-6309

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kmasterson291792@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: kelsey.masterson.1@25843.direct.athenahealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1821531070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160748",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327160748",
            "telephone_number": "561-253-3980",
            "fax_number": "561-253-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 S CONGRESS AVE STE 200",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612171",
            "telephone_number": "561-253-3980",
            "fax_number": "561-253-3985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11621 Kew Gardens Ave Ste 101A",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334102853",
            "country_code": "US",
            "telephone_number": "561-253-3980",
            "fax_number": "561-253-3985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111251",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "23.003728",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9111251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

Verify at the official NPI Registry.