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

Individual provider Physician Assistant · NPI 1669209763

Elyse Kiele Koe, PA-C is a Physician Assistant in Camarillo, California. Qualified in 2024, 2 years ago. Practices with Sbh Physicians PC, a 177-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2024
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

1199 Lantana St
Camarillo, CA 93010-3024
Phone: (805) 914-9503
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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 1223458 (NY)

Record details

NPI number1669209763
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 14, 2024
Last updated in NPPESSeptember 14, 2024
Certification dateSeptember 14, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Sbh Physicians Pc — 177 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Camarillo