Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Edna Kabisa, PA-C

Individual provider Medical Physician Assistant · NPI 1689455230

Edna Kabisa, PA-C is a Physician Assistant in Raleigh, North Carolina. Qualified in 2022, 4 years ago. Practices with North Carolina Mg LLC, a 712-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone: (919) 784-3542
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-13397 (NC)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 0010-13397 (NC)

Record details

NPI number1689455230
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 10, 2023
Last updated in NPPESJune 17, 2025
Certification dateJune 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice North Carolina Mg Llc — 712 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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