Individual provider Active NPI

Katherine King, PA-C

  • Physician Assistant
  • Aliso Viejo, CA
National Provider Identifier
1922332410
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5 Journey Ste 210
Aliso Viejo, CA 92656-5332
Phone
(949) 305-7122
Fax
(949) 305-7160
NPI assigned
Sep 30, 2009
Last updated
Jul 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

5 Journey Ste 210
Aliso Viejo, CA 92656-5332

Mailing address

5 Journey Ste 210
Aliso Viejo, CA 92656-5332
Phone (949) 305-7122

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
I20250312003799 CA Practitioner - Physician Assistant 6800013111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Western University of Health Sciences College of Dental Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sandeep Thakkar DO a Professional CorporationGroup PAC ID 4688019722, 4 clinicians

Practice addresses (Care Compare)

1310 W Stewart Dr
Suite 602
Orange, CA 92868-3857
Phone (714) 602-9891

16405 Sand Canyon Ave
Suite 265
Irvine, CA 92618-3792

Hospital & facility affiliations

National Provider Directory

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404864000000",
    "number": "1922332410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 JOURNEY STE 210",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565332",
            "telephone_number": "949-305-7122",
            "fax_number": "949-305-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 JOURNEY STE 210",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565332",
            "telephone_number": "949-305-7122",
            "fax_number": "949-305-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2014-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

Verify at the official NPI Registry.