Active NPI
Michelle Deanne Kostner, P.A.
- Medical Physician Assistant
- San Diego, CA
National Provider Identifier
1891197943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 51929
- Practice address
- 10605 Scripps Poway Pkwy
#C
San Diego, CA 92131-3925 - Phone
- (858) 622-0554
- NPI assigned
- Sep 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 51929 | CA | Primary |
Addresses
Primary practice location
10605 Scripps Poway Pkwy
#C
San Diego, CA 92131-3925
Mailing address
12521 Mustang Dr
Poway, CA 92064
Phone (714) 458-7543
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10605 Scripps Poway Pkwy
San Diego, CA 92131-3925
Phone (858) 622-0554
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patient First Richmond Medical Group PLLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Urgent Care Clinic/Center
- San Diego, CA
- NPI 1750644258
-
- Urgent Care Clinic/Center
- San Diego, CA
- NPI 1275909434
-
- Family Medicine Physician
- Glen Allen, VA
- NPI 1689603748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490140800000",
"number": "1891197943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12521 MUSTANG DR",
"city": "POWAY",
"state": "CA",
"postal_code": "92064",
"telephone_number": "714-458-7543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10605 SCRIPPS POWAY PKWY",
"address_2": "#C",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921313925",
"telephone_number": "858-622-0554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSTNER",
"first_name": "MICHELLE",
"middle_name": "DEANNE",
"name_prefix": "Mrs.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-19",
"last_updated": "2017-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "51929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.