Individual provider Active NPI

Kristin Burgess McBride, PA-C

  • Emergency Medical Services (Emergency Medicine) Physician
  • Oakland, CA
National Provider Identifier
1841709979
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
54668 Issued in CA
Practice address
350 Hawthorne Ave
Oakland, CA 94609-3108
Phone
(925) 962-1800
NPI assigned
Sep 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 54668 CA Primary

Addresses

Primary practice location

350 Hawthorne Ave
Oakland, CA 94609-3108

Mailing address

254 Clinton Park
San Francisco, CA 94103-1005
Phone (617) 233-7060

Other practice location 1

2450 Ashby Ave
Berkeley, CA 94705-2067
Phone (925) 962-1800

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
I20180122000097 CA Practitioner - Physician Assistant 4284993288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley Emergency Medical Group, Inc. CurrentSince Nov 30, 2017 Accepting new patients

Locations

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

Interoperability endpoints

  • Direct secure messaging: kristin.mcbride.1@25843.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1841709979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 CLINTON PARK",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941031005",
            "telephone_number": "617-233-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HAWTHORNE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093108",
            "telephone_number": "925-962-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Ashby Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052067",
            "country_code": "US",
            "telephone_number": "925-962-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "KRISTIN",
        "middle_name": "BURGESS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "54668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.