Individual provider Active NPI

Katrina L Lelli, RPAC

  • Physician Assistant
  • Stuart, FL
National Provider Identifier
1013126853
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1400 NW Federal Hwy
Stuart, FL 34994-1020
Phone
(772) 888-1880
Fax
(855) 618-2315
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1400 NW Federal Hwy
Stuart, FL 34994-1020

Mailing address

1400 NW Federal Hwy
Stuart, FL 34994-1020
Phone (772) 888-1880

Other identifiers 2

IdentifierTypeStateIssuer
1PKD4OtherFLFLORIDA BLUE
P00819028OtherRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171014000107 FL Practitioner - Physician Assistant 7618065541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Ear, Nose and Throat LLCGroup PAC ID 1254680481, 9 clinicians

Practice addresses (Care Compare)

1400 NW Federal Hwy
Stuart, FL 34994-1020
Phone (772) 888-1880

1400 NW US
Suite 1
Stuart, FL 34994-1020
Phone (772) 888-1880

Hospital & facility affiliations

  • Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260

Merit-based Incentive Payment System (MIPS)

Final score
84.38 of 100Reported as group
Quality
81.3
Improvement activities
40
Cost
72.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2519MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hilary J. Cholhan, MD, PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEFDCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/BEFDCD/Endpoint/BEFDCD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1013126853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349941020",
            "telephone_number": "772-888-1880",
            "fax_number": "855-618-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349941020",
            "telephone_number": "772-888-1880",
            "fax_number": "855-618-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LELLI",
        "first_name": "KATRINA",
        "middle_name": "L",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "1PKD4",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00819028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.