Individual provider Active NPI

Kevin Eugene Hearn, PA-C

  • Medical Physician Assistant
  • Oceanside, CA
National Provider Identifier
1932585361
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
52488 Issued in CA
Practice address
3905 Waring Rd
Oceanside, CA 92056-4405
Phone
(760) 724-9000
Fax
(760) 724-3686
NPI assigned
Aug 7, 2015
Last updated
Mar 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 52488 CA Primary
Surgical Physician Assistant 363AS0400X PA52488 CA

Addresses

Primary practice location

3905 Waring Rd
Oceanside, CA 92056-4405

Mailing address

3905 Waring Rd
Oceanside, CA 92056-4405

Other identifiers 1

IdentifierTypeStateIssuer
PA52488OtherCACA MEDICAL LICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khearn43680@edirect.emc.org Health Information Exchange (HIE)

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
I20150923002815 CA Practitioner - Physician Assistant 8325355381 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA52488CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Sep 1, 2015 Accepting new patients
Cep America-California CurrentSince Sep 1, 2015 Accepting new patients
Tri-City Orthopaedic Surgery Medical Group Inc CurrentSince Dec 9, 2021 Accepting new patients
Tri City Orthopaedic Surgery Medical Group Inc CurrentSince Dec 9, 2021 Accepting new patients
Desert Orthopedic Center a Medical Group Inc PastSince Nov 24, 2019 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3905 Waring Rd
Oceanside, CA 92056
Phone (760) 477-1350

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

Interoperability endpoints

  • Direct secure messaging: khearn@osnc2021.srs-direct.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1932585361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 WARING RD",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 WARING RD",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564405",
            "telephone_number": "760-724-9000",
            "fax_number": "760-724-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARN",
        "first_name": "KEVIN",
        "middle_name": "EUGENE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-07",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "52488",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA52488",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE #",
            "identifier": "PA52488",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khearn43680@edirect.emc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "39000 Bob Hope Dr",
            "address_2": "Harry & Diane Rinker Building",
            "city": "Rancho Mirage",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922703221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.