Individual provider Active NPI

Kelly Marie McBratney, PA-C

  • Medical Physician Assistant
  • Anaheim, CA
National Provider Identifier
1942877097
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA59607 Issued in CA
Practice address
631 S Brookhurst St Ste 101
Anaheim, CA 92804-3563
Phone
(714) 991-5700
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA59607 CA Primary

Addresses

Primary practice location

631 S Brookhurst St Ste 101
Anaheim, CA 92804-3563

Mailing address

12671 Shasta Way
Santa Ana, CA 92705-1142
Phone (714) 222-0548

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
I20230613002766 CA Practitioner - Physician Assistant 0941667521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oc Urgentcare Medical Group IncorporatedGroup PAC ID 3375672835, 30 clinicians

Practice addresses (Care Compare)

23653 El Toro Rd
Suite B
Lake Forest, CA 92630-8614
Phone (949) 317-0312

26781 Portola Pkwy
Suite 4E
Foothill Ranch, CA 92610-1758
Phone (949) 297-3888

631 S Brookhurst St
Suite 101
Anaheim, CA 92804-3563
Phone (714) 991-5700

Hospital & facility affiliations

  • Southwest Healthcare Rancho Springs Hospital Hospital, Murrieta, CA, CCN 050701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA59607CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Oc Urgentcare Medical Group Incorporated CurrentSince May 6, 2023 Accepting new patients

Locations

631 S Brookhurst St
Ste 101
Anaheim, CA 92804
Phone (714) 991-5700

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.

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": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1942877097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12671 SHASTA WAY",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927051142",
            "telephone_number": "714-222-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S BROOKHURST ST STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043563",
            "telephone_number": "714-991-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRATNEY",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA59607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.