KELLY B NGUYEN PA-C
NPI 1730892803
Physician Assistant in San Francisco, CA

Q: What is Kelly Nguyen's NPI number?

The NPI number for Kelly Nguyen is 1730892803. It was assigned to this individual provider in the NPPES registry on January 3, 2023.

Q: What is Kelly Nguyen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Nguyen was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since January 03, 2023PECOS EnrolledAccepts Medicare Assignment

3838 CALIFORNIA ST RM 805, SAN FRANCISCO, CA 94118(415) 600-5400(415) 387-0730 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 4, 2025, Jan 3, 2023 (2 updates tracked since 2023).

On this page

About Kelly B Nguyen Pa-c NPPES

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

KELLY B NGUYEN PA-C (NPI 1730892803) is an individual physician assistant in San Francisco, California, licensed in California (PA66630) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Vallejo, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1730892803

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLY B NGUYENCredential: PA-C

Location Address3838 CALIFORNIA ST RM 805San Francisco, CA 94118-1510

Mailing AddressPo Box 276950Sacramento, CA 95827-6950 · (866) 681-0738 · Fax (916) 854-6769

Phone(415) 600-5400

Fax(415) 387-0730

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateJanuary 3, 2023

Last NPPES UpdateDecember 4, 20252 updates tracked since enumeration

NPPES CertifiedDecember 4, 2025

✔ NPI 1730892803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA66630

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3838 CALIFORNIA ST RM 805, San Francisco, CA 94118

Open in Google Maps ↗

Secondary Practice Location 1

Location 11310 Club DrVallejo, CA 94592-1187 · Phone (707) 638-5809

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly B Nguyen Pa-c 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 ID2062904675

PECOS Enrollment IDI20251121001174

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94118 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 12

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

RICHARD THOMAS DIBELLA PA

Physician Assistant