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KELLY GRACE WYNKOOP DC
NPI 1184404196
Chiropractor in Manhattan Beach, CA

Active since October 05, 2023Accepts Medicare Assignment
400 S SEPULVEDA BLVD STE 247, MANHATTAN BEACH, CA 90266(310) 798-6496 Get Directions Write a Review

NPPES record last updated: October 5, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kelly Grace Wynkoop Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY GRACE WYNKOOP DC (NPI 1184404196) is an individual chiropractor in Manhattan Beach, California, licensed in California (36764) and active in the NPI registry since October 2023. She is a graduate of University Of Southern California Keck School Of Medicine (2022).

NPPES Registry Identity

NPI1184404196
Entity TypeIndividualFemale
Primary Taxonomy111N00000X
Provider Legal NameKELLY GRACE WYNKOOPCredential: DC
Location Address400 S SEPULVEDA BLVD STE 247Manhattan Beach, CA 90266-6876
Mailing Address936 1st St Apt 2Hermosa Beach, CA 90254-5365 · (631) 384-2511
Phone(310) 798-6496
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2022
Enumeration DateOctober 5, 2023
NPPES CertifiedOctober 3, 2023
✔ NPI 1184404196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in CA · 36764
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
400 S SEPULVEDA BLVD STE 247, Manhattan Beach, CA 90266
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Grace Wynkoop Dc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608226519
PECOS Enrollment IDI20231219000507

Medicare Billing Reassignment

Medicare enrollment records show Kelly Wynkoop reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Beach Cities Orthopedics And Sports Medicine
Same address
Orthopaedic Surgery
400 S SEPULVEDA BLVD, SUITE 200
Manhattan Beach, CA 90266
  • Reassigned Medicare billing, California enrollment
  • 39 clinicians in this Medicare group
NPI 1750539672 (310) 546-3461

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 1-2 spinal regions 98940
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.
139 services16 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CAMILLE GARCIA MARZAN DC
Chiropractor
400 S SEPULVEDA BLVD STE 247
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 798-6496
DR. AUSTYN LYNN YARBROUGH DC
Chiropractor
400 S SEPULVEDA BLVD STE 247
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 798-6496
COURTLAND MCCOY DC
Chiropractor
400 S SEPULVEDA BLVD STE 247
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 798-6496
DR. JOHN YOON DACM, L.AC
Acupuncturist
400 S SEPULVEDA BLVD STE 247
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 798-6496
NICOLLE PISMAROV D.C.
Chiropractor
400 S SEPULVEDA BLVD STE 247
MANHATTAN BEACH, CA 90266
Los Angeles County (310) 798-6496

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Wynkoop's NPI number?

The NPI number for Kelly Wynkoop is 1184404196. It was assigned to this individual provider in the NPPES registry on October 5, 2023.

Where is Kelly Wynkoop located?

Kelly Wynkoop practices at 400 S Sepulveda Blvd Ste 247, Manhattan Beach, CA 90266. The listed phone number is (310) 798-6496.

What is Kelly Wynkoop's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kelly Wynkoop enrolled in Medicare?

Yes. Kelly Wynkoop is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kelly Wynkoop's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Wynkoop reassigns Medicare benefits to Beach Cities Orthopedics And Sports Medicine (Manhattan Beach, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Wynkoop's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Wynkoop was last updated on October 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.