Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelsie Mothersead

Individual provider Physician Assistant · NPI 1508555210

Kelsie Mothersead is a Physician Assistant in Newport Beach, California. Qualified in 2023, 3 years ago. Practices with Lakeshore Bone and Joint Institute II, LLC, a 9-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

22 Corporate Plaza Dr
Newport Beach, CA 92660-7985
Phone: (949) 722-7038
Fax: (949) 630-4900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1508555210
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 8, 2023
Last updated in NPPESJune 26, 2026
Certification dateJune 26, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Lakeshore Bone And Joint Institute Ii, Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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