Kelly Lynn Walsma, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2011019861 Issued in MO

Practice address

1983 Marengo St
Los Angeles, CA 90033-1370

Phone

(323) 226-2622

NPI assigned

Jul 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SCCT Medical Group PCGroup PAC ID 4183978026, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Mayo Newhall Hospital Hospital, Valencia, CA, CCN 050624

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• SCCT Medical Group, PC

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1952878795
  Medicare reassignment Care Compare group NPD Authorized official
• Emergency Associates Corporation

  • Emergency Medicine Physician
  • Rancho Mirage, CA
  • NPI 1003866120
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of California, Inc

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1184663965
  Medicare reassignment NPD
• Valencia Pulmonary Medical Group Inc.

  • Pulmonary Disease Physician
  • Newhall, CA
  • NPI 1932100070
  Medicare reassignment NPD
• Santa Clarita Cardiology Medical Group, Inc.

  • Cardiovascular Disease Physician
  • Newhall, CA
  • NPI 1619028149
  NPD
• Henry Mayo Newhall Memorial Hospital

  dba Henry Mayo Newhall Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  NPD (past)
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306

  Internal Medicine

  NPD (past)

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

• Henry Mayo Newhall Memorial Hospital

  dba Henry Mayo Newhall Hospital

  • General Acute Care Hospital
  • Valencia, CA
  • NPI 1780668434
  Care Compare affiliation

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1215225321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331370",
            "telephone_number": "323-226-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 MARENGO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331370",
            "telephone_number": "323-226-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSMA",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2011019861",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A130686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Lauren Walsh, MA
• Meagan A Walsh, LMFT #104843
• Tyler Walsh
• Patricia Denise Walshaw, PH.D.
• Joanne Walshe
• Amy K Walston, MD
• Walt Jay Medical Corporation (Integrative Industrial and Family Practice Medical Clinics)
• Walt Jay Medical Corporation (Integrative Industrial and Family Practice Medical Clinics)
• Walt Jay Medical Corporation (Integrative Industrial & Family Practice Medical Clinics)
• Walt Jay Medical Corporation (Integrative Industrial and Family Practice Medical Clinics)

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.