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DR. KAILYNE ASHE VAN STAVERN M.D.
NPI 1841678232
Pediatrics in Orange, CA

Active since May 18, 2015PECOS Enrolled
505 S MAIN ST STE 525, ORANGE, CA 92868(714) 456-5631(714) 285-0389 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 17, 2021, Aug 14, 2018 (2 updates tracked since 2018).

About Dr. Kailyne Ashe Van Stavern M.d. NPPES

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

DR. KAILYNE ASHE VAN STAVERN M.D. (NPI 1841678232) is an individual pediatrics provider in Orange, California, licensed in California (A146961) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841678232
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. KAILYNE ASHE VAN STAVERNCredential: M.D.
Location Address505 S MAIN ST STE 525Orange, CA 92868-4553
Mailing Address505 S Main St Ste 525Orange, CA 92868-4553 · (714) 456-5631 · Fax (714) 285-0389
Phone(714) 456-5631
Fax(714) 285-0389
Sole ProprietorNo
Enumeration DateMay 18, 2015
Last NPPES UpdateDecember 17, 20212 updates tracked since enumeration
✔ NPI 1841678232 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A146961
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
505 S MAIN ST STE 525, Orange, CA 92868
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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 (PECOS)

Dr. Kailyne Ashe Van Stavern M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

4

Medicare enrollment records show Kailyne Van Stavern reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Uc Regents Uci Dept Of Pediatrics
1.4 mi
Pediatrics
101 THE CITY DR S
Orange, CA 92868
  • Reassigned Medicare billing, California enrollment
  • 143 clinicians in this Medicare group
NPI 1235187311 (714) 456-8068
University Of California Irvine
2.0 mi
Federally Qualified Health Center (FQHC)
800 N MAIN ST
Santa Ana, CA 92701
  • Reassigned Medicare billing, California enrollment
  • 255 clinicians in this Medicare group
NPI 1851325906 (714) 456-6785
Permanente Medical Group Inc
338 mi
Internal Medicine
710 LAWRENCE EXPRESSWAY
Santa Clara, CA 95051
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1073606299 (408) 851-1000
Weill Medical College Of Cornell University
2,439 mi
Internal Medicine
40 WORTH ST
New York, NY 10013
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Weill Medical College Of Cornell
  • 980 clinicians in this Medicare group
NPI 1801188313 (212) 590-5741

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92868 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
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 20

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

LINDSEY LILL
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
ESTHER CHANG
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (925) 785-6878
LUKE YU MD
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 456-5631
CHARISSA LAU
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
MARIA NGUYEN DO
Pediatrics
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
REGINA TANG
Student in an Organized Health Care Education/Training Program
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 509-8547
DEAN TODD MD
Pediatrics
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 456-5631
KATHERINE ALOYSIUS KILLMOND
Pediatrics
505 S MAIN ST STE 525
ORANGE, CA 92868
Orange County (714) 456-5631

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 Kailyne Van Stavern's NPI number?

The NPI number for Kailyne Van Stavern is 1841678232. It was assigned to this individual provider in the NPPES registry on May 18, 2015.

Where is Kailyne Van Stavern located?

Kailyne Van Stavern practices at 505 S Main St Ste 525, Orange, CA 92868. The listed phone number is (714) 456-5631.

What is Kailyne Van Stavern's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kailyne Van Stavern enrolled in Medicare?

Yes. Kailyne Van Stavern is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kailyne Van Stavern's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kailyne Van Stavern reassigns Medicare benefits to 4 organizations: Uc Regents Uci Dept Of Pediatrics (Orange, CA), University Of California Irvine (Santa Ana, CA), Permanente Medical Group Inc (Santa Clara, CA) and Weill Medical College Of Cornell University (New York, NY). Each 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 Kailyne Van Stavern'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 Kailyne Van Stavern was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.