Individual provider Active NPI

Kasie Palmer, PA-C

  • Surgical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1871964676
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
60969 Issued in CA
Practice address
2615 Box Canyon Dr
Las Vegas, NV 89128-0450
Phone
(702) 998-9001
Fax
(702) 998-8282
NPI assigned
Oct 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6263 NV
Medical Physician Assistant 363AM0700X PA1676 NV
Surgical Physician Assistant 363AS0400X 60969 CA Primary

Addresses

Primary practice location

2615 Box Canyon Dr
Las Vegas, NV 89128-0450

Mailing address

PO Box 35914
Las Vegas, NV 89133-5914
Phone (702) 485-5300

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
I20220725003337 CA Practitioner - Physician Assistant 2163725615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

1074 Murrieta Blvd
Livermore, CA 94550-4111
Phone (925) 443-0980

355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704

6155 Stoneridge Dr
Suite 150
Pleasanton, CA 94588-6500
Phone (925) 251-9012

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60969CAMDPharmacist
6263NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. CurrentSince Sep 1, 2022 Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

1074 Murrieta Blvd
Livermore, CA 94550
Phone (925) 277-1300

6155 Stoneridge Dr
Ste 150
Pleasanton, CA 94588
Phone (925) 251-9012

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

Organizations & group practices 2

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": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1871964676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35914",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335914",
            "telephone_number": "702-485-5300",
            "fax_number": "702-750-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 BOX CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280450",
            "telephone_number": "702-998-9001",
            "fax_number": "702-998-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "KASIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "6263",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1676",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "60969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.