Kayla Lodge, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00409800 Issued in NJ

Practice address

325 Princeton Ave
Princeton, NJ 08540-1698

Phone

(609) 924-8131

Fax

(609) 924-8532

NPI assigned

Sep 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kayla Kelly Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Orthonj LLCGroup PAC ID 6800225178, 302 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Orthonj LLC

  • Orthopaedic Surgery Physician
  • Somerset, NJ
  • NPI 1720557432
  Medicare reassignment Care Compare group NPD
• New Jersey Healthcare Specialists PC

  • Anesthesiology Physician
  • Hackensack, NJ
  • NPI 1174585780
  Medicare reassignment Care Compare group
• Orthonj LLC

  • Durable Medical Equipment & Medical Supplies
  • Galloway, NJ
  • NPI 1487448312
  NPD

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

• Princeton Healthcare System, a New Jersey Non-Profit Corporation

  • General Acute Care Hospital
  • Plainsboro, NJ
  • NPI 1689714255
  Care Compare affiliation

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1174071625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401698",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401698",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODGE",
        "first_name": "KAYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00409800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "KELLY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samuel M Liu, M.D.
• Rachel L Livecchi, P.A.
• LMG M.D., Inc.
• Locklab Provider Group NJ, P.C.
• Daniel James Lodge, PA-C
• Catherine Ann Long, APN
• Louis J Russo Jr Jonathan L Nicozisis DMD Ms PA
• Charis Louissaint
• Nickolas Low-Beer, RDN, RN
• Deborah C. Lowden Donahue, R.D.

• Physician Assistant in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.