Mallory Lambert Carletti, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10208 Issued in TX

Practice address

808 Keller Pkwy
Keller, TX 76248-2405

Phone

(817) 431-2573

Fax

(817) 379-6881

NPI assigned

Nov 17, 2015

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 names 1

• Mallory Brooke Lambert Former name

Medicare fee-for-service enrollment

Enrolled in TX

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patrick Keehan DO PAGroup PAC ID 6406286095, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Patrick Keehan DO PA

  • Dermatology Physician
  • Fort Worth, TX
  • NPI 1811533805
  Medicare reassignment Care Compare group
• Keller Family Medical Center, PLLC

  • Family Medicine Physician
  • Keller, TX
  • NPI 1407489347
  Medicare reassignment

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1134593957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573",
            "fax_number": "817-379-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 KELLER PKWY",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762482405",
            "telephone_number": "817-431-2573",
            "fax_number": "817-379-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLETTI",
        "first_name": "MALLORY",
        "middle_name": "LAMBERT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-17",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "LAMBERT",
            "middle_name": "BROOKE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lynette Cannon, LM, CPM
• Dennis Nguyen Cao, DMD
• Callie Caraballo, RDMS
• Nicole Elizabeth Cardamone
• Careride Express LLC
• Martrice Tashae Carradine
• Alexia Carrion, M.S., BCBA, LBA
• Kaylin Carruthers
• Grady Lee Carter III, D.O.
• Brittany M Cartwright, MS, CCC-SLP

• Physician Assistant in Keller, TX
• Providers in Keller, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.