Kirt Lee Edly, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21381 Issued in CA

Practice address

39000 Bob Hope Dr, Harry & Diane Rinker Building
Rancho Mirage, CA 92270-3221

Phone

(760) 568-2684

Fax

(760) 341-5832

NPI assigned

Jul 11, 2008

Last updated

Apr 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Desert Orthopedic Center a Medical Group IncGroup PAC ID 2466346739, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Merit-based Incentive Payment System (MIPS)

Final score

82.54 of 100Reported as group

Quality

77.5

Promoting interoperability

99

Improvement activities

40

Cost

65.14

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Desert Orthopedic Center a Medical Group Inc

  dba Desert Orthopedic Center

  • Orthopaedic Surgery Physician
  • Rancho Mirage, CA
  • NPI 1508967753
  Medicare reassignment Care Compare group
• Desert Orthopedic Center a Medical Group Inc

  dba Desert Orthopedic Pain Management Clinic

  • Durable Medical Equipment & Medical Supplies
  • Rancho Mirage, CA
  • NPI 1598301764
  NPD (past)
• Chiropractic Connection LTD

  • Chiropractor
  • Melrose Park, IL
  • NPI 1679796973
  NPD (past)
• Vy Huong Hoang DC PC

  dba The Chiropractic Connection

  • Chiropractor
  • Oakbrook Terrace, IL
  • NPI 1295010361
  NPD (past)

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

• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1053575746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1730",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701058",
            "telephone_number": "760-568-2684",
            "fax_number": "760-341-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR, HARRY & DIANE RINKER BUILDING",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "760-568-2684",
            "fax_number": "760-341-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDLY",
        "first_name": "KIRT",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-11",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21381",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA21381",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "PA21381",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kedly49432@edirect.emc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "39000 Bob Hope Dr",
            "address_2": "Harry & Diane Rinker Building",
            "city": "Rancho Mirage",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922703221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Verlie Duvall
• Harutyun Dzhabrayan
• Lawrence Earl, MD
• Robin June Edberg, PTA
• Edc Anesthesia Nursing PC
• Diane M Edward, RPT PHYS THERAPIST
• Tina Marie Egner, APRN, CNM
• Ruby Ann Eguez, FNP-C
• John P Einck, MD
• Eisenhower Medical Associates, Inc.

• Medical Physician Assistant in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.