Kacie Kline Condon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61679 Issued in CA

Practice address

420 E 3Rd St Ste 805
Los Angeles, CA 90013-1646

Phone

(213) 218-3915

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kacie Allison Kline Former name

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Irradiance Medical Group IncGroup PAC ID 2860534864, 6 clinicians

Blair S Kranson M D IncGroup PAC ID 7416072319, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Blair S Kranson M D Inc

  • Dermatology Physician
  • West Hills, CA
  • NPI 1376750224
  Medicare reassignment Care Compare group
• Irradiance Medical Group Inc

  • Procedural Dermatology Physician
  • Los Angeles, CA
  • NPI 1740213198
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1942924907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 PORT CHELSEA PL",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605349",
            "telephone_number": "949-922-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 3RD ST STE 805",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131646",
            "telephone_number": "213-218-3915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17271 Brookhurst St",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927083701",
            "country_code": "US",
            "telephone_number": "714-531-2966",
            "fax_number": "714-531-3495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDON",
        "first_name": "KACIE",
        "middle_name": "KLINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACIE",
            "last_name": "KLINE",
            "middle_name": "ALLISON",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jose Conde, PHARMACIST
• Mayra Conde
• Miriam Hernanda Conde
• Teana Condiff
• Ashwinee Satish Condon, MD
• Taylor Condran, PA-C
• Brian Daniel Cone, D.O.
• Conejo Valley Outpatient Center, LLC
• Andrea Conejo-Toledo
• James Henry Cones III, PH.D.

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.

Verify at the official NPI Registry.