Individual provider Active NPI

Kaley Rae Speros Lamas, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1043606262
Registry record updated Aug 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7530 Issued in GA
Practice address
59 Executive Park S
Ste 3000
Atlanta, GA 30329-2208
Phone
(404) 778-6227
Fax
(404) 778-6310
NPI assigned
Apr 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2019

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 7530 GA Primary

Addresses

Primary practice location

59 Executive Park S
Ste 3000
Atlanta, GA 30329-2208

Mailing address

59 Executive Park S
Ste 3000
Atlanta, GA 30329-2208
Phone (404) 778-6227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20150728004475 GA Practitioner - Physician Assistant 9830403310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007530GAMDProfessional Counselor
7530GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Jun 1, 2015 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

59 Executive Park South NE
Ste 3000
Atlanta, GA 30329
Phone (404) 778-6227

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: klamas44945@direct.emory.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1043606262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S",
            "address_2": "STE 3000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-6227",
            "fax_number": "404-778-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK S",
            "address_2": "STE 3000",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-6227",
            "fax_number": "404-778-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMAS",
        "first_name": "KALEY",
        "middle_name": "RAE SPEROS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.