Individual provider Active NPI

Kirk Kay Austin, PA

  • Medical Physician Assistant
  • Elk Grove, CA
National Provider Identifier
1962848374
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10387 Issued in CA
Practice address
9590 Oakham Way
Elk Grove, CA 95757-5122
Phone
(916) 685-3673
NPI assigned
May 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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 PA10387 CA Primary

Addresses

Primary practice location

9590 Oakham Way
Elk Grove, CA 95757-5122

Mailing address

9913 Winkle Cir
Elk Grove, CA 95757-6277
Phone (916) 385-4438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10387CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Clinical Research, Inc. CurrentSince Jul 8, 2015 Accepting new patients
Elk Grove Rehab & Counseling Center Current Accepting new patients

Locations

3000 L St
Ste 100
Sacramento, CA 95816
Phone (916) 454-5729

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.

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1962848374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9913 WINKLE CIR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957576277",
            "telephone_number": "916-385-4438",
            "fax_number": "916-897-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9590 OAKHAM WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957575122",
            "telephone_number": "916-685-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN",
        "first_name": "KIRK",
        "middle_name": "KAY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA10387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.