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

Kevin A Kissoon, PA

Individual provider Physician Assistant · NPI 1124796289

Kevin A Kissoon, PA is a Physician Assistant in Brookhaven, Georgia. Qualified in 2022, 4 years ago. Practices with Guidewell Emergency Medicine Doctors, LLC, a 90-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1377 Dresden Dr NE
Brookhaven, GA 30319-3400
Phone: (407) 620-2007
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1124796289
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 2, 2021
Last updated in NPPESSeptember 2, 2021
Certification dateAugust 27, 2021

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 Guidewell Emergency Medicine Doctors, Llc — 90 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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