Kelsi V Walla, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2018-0032 Issued in NM

Practice address

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Phone

(480) 751-9804

NPI assigned

May 31, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelsey V Sullivan Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unm HospitalGroup PAC ID 7618889528, 394 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unm Hospital Hospital, Albuquerque, NM, CCN 320001

Merit-based Incentive Payment System (MIPS)

Final score

91.83 of 100Reported as group

Quality

83.58

Promoting interoperability

100

Improvement activities

40

Cost

72.52

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Unm Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1689747552
  Medicare reassignment Care Compare group
• Unm Hospital

  • Air Ambulance
  • Albuquerque, NM
  • NPI 1558054684
  NPD

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

• Unm Hospital

  • Air Ambulance
  • Albuquerque, NM
  • NPI 1558054684

  Hospital

  Care Compare affiliation
• Unm Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1689747552
  Care Compare affiliation

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1063904464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "480-751-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLA",
        "first_name": "KELSI",
        "middle_name": "V",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2018-0032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA2018-0032",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "SULLIVAN",
            "middle_name": "V",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Irene Walkiw, DOM
• Byron W. Wall, D.D.S
• Karen Wall, EDD, LMFT, RN-BC
• Laura Wall, SLP
• Taylour Wall, SLP-CF
• Jessica Erin Wallace Woodard, LPCC, CEAP
• Marci Ann Wallace-Innerhoffer, SLP
• Brenda Wallace, SLP
• Craig Wallace
• Demetre Wallace, CHW

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

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