Starla N. Lyles McKelvy, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A14833 Issued in CA

Practice address

12625 Hesperia Rd
Victorville, CA 92395-7720

Phone

(760) 995-8300

Fax

(760) 995-8300

NPI assigned

Jun 20, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mrs. Starla Nicole Lyles Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

88.87 of 100Reported as group

Quality

72.13

Promoting interoperability

80

Improvement activities

40

Cost

77.36

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: starla.lyles-mckelvy.1@14035.direct.athenahealth.com
• Direct secure messaging: slylesmckelvy900760@direct.llu.edu

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.

• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Bernardino, CA
  • NPI 1164467023

  Single Specialty

  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917

  Single Specialty

  Medicare reassignment NPD
• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apple Valley, CA
  • NPI 1346950904

  Single Specialty

  NPD
• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Victorville, CA
  • NPI 1699984997

  Single Specialty

  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Loma Linda, CA
  • NPI 1477503407
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331

  Single Specialty

  NPD

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1023303922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957720",
            "telephone_number": "209-381-6800",
            "fax_number": "760-995-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957720",
            "telephone_number": "760-995-8300",
            "fax_number": "760-995-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLES MCKELVY",
        "first_name": "STARLA",
        "middle_name": "N.",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102203199",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "20A14833",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A14833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STARLA",
            "last_name": "LYLES",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Muhammad Luqman, MBBS, MD
• Annie Tran Luu, RPH
• Lillian Luu
• Luxottica of America Inc.
• Lydia a Cruz MD Inc
• Nishika Y Lyles
• Anique Lynch
• Evonne Martha Torres Tirado Lynch, LPCC
• Kallie Kathleen Lynch, DPT, PT
• Christina Macfarland

• Psychiatry Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.