Kelly Christine Boal, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

200456 Issued in LA

Practice address

5439 Airline Hwy
Baton Rouge, LA 70805-1712

Phone

(225) 358-4853

NPI assigned

Jun 23, 2011

Last updated

Feb 27, 2026By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Medical Center - Baton Rouge Hospital, Baton Rouge, LA, CCN 190202

Merit-based Incentive Payment System (MIPS)

Final score

99.76 of 100Reported as group

Quality

87.95

Improvement activities

40

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Ascension Emergency Physicians LLC

  • Emergency Medicine Physician
  • Gonzales, LA
  • NPI 1699118505
  Medicare reassignment
• C & M Medical Services, Inc.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Metairie, LA
  • NPI 1710903059
  Medicare reassignment
• Mayfair Emergency Group, LLC

  • Emergency Medicine Physician
  • Baton Rouge, LA
  • NPI 1750870226
  Medicare reassignment
• Our Lady of the Lake Physician Group LLC

  dba Our Lady of the Lake Children's Health Developmental Center at McMains

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD

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

• East Baton Rouge Medical Center LLC

  dba Ochsner Medical Center Baton Rouge

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1053360651
  Care Compare affiliation

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1215223763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-358-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5439 AIRLINE HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708051712",
            "telephone_number": "225-358-4853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7777 Hennessy Blvd",
            "address_2": "SUITE 211",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084300",
            "country_code": "US",
            "telephone_number": "225-765-7163",
            "fax_number": "405-341-9217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOAL",
        "first_name": "KELLY",
        "middle_name": "CHRISTINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "200456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2165623",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharine Elizabeth Blum, LPC
• Vincent Michael Blum, M.D.
• Constance Cole Blunt, M.D.
• Jeremy Lucas Blunt, MTH, PSY.D
• Kymber Bly, BS, OTC
• Lyle Everett Board, ATC, CSCS
• Letisha R Boast
• Kaia Boatner
• Rain Aspen Boatner
• Reva Boatner

• Physician Assistant in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.