Individual provider Active NPI

Kristine Sue Percy, M.D.,

  • Family Medicine Physician
  • Brea, CA
National Provider Identifier
1972697605
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G77388 Issued in CA
Practice address
539 South Brea Blvd
Brea, CA 92821
Phone
(714) 671-2936
Fax
(714) 671-2938
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G77388 CA Primary

Addresses

Primary practice location

539 South Brea Blvd
Brea, CA 92821

Mailing address

539 South Brea Blvd
Brea, CA 92821
Phone (714) 671-2936

Other identifiers 3

IdentifierTypeStateIssuer
1306971262OtherCAGROUP NPI
GR0101050MedicaidCA
ZZZ092862OtherBLUE SHIELD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000311 CA Practitioner - Family Practice 7113987025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

539 S Brea Blvd
Brea, CA 92821-5377
Phone (714) 671-2936

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kristine Percy MD & Lauren Stearns MD, Inc. Family Medicine CurrentSince Aug 1, 2004 Accepting new patients

Locations

539 S Brea Blvd
Ste 100
Brea, CA 92821
Phone (714) 671-2936

539 S Brea Blvd
Brea, CA 92821
Phone (714) 671-2936

539 S Brea Blvd
Fl 1
Brea, CA 92821
Phone (714) 671-2936

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1972697605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 SOUTH BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "92821",
            "telephone_number": "714-671-2936",
            "fax_number": "714-671-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 SOUTH BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "92821",
            "telephone_number": "714-671-2936",
            "fax_number": "714-671-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCY",
        "first_name": "KRISTINE",
        "middle_name": "SUE",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G77388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1306971262",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101050",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ092862",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.