Keala Kaaikala, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

12550 Hesperia Rd Ste 100
Victorville, CA 92395-5873

Phone

(760) 381-7703

NPI assigned

Jul 8, 2019

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

Electronic endpoints 1

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: 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

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bear Valley Community Hospital Hospital, Big Bear Lake, CA, CCN 051335

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkaaikala1374524@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

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

• Bear Valley Community Health Care District

  • Long Term Care Pharmacy
  • Big Bear Lake, CA
  • NPI 1073553756

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1245892454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6231 W STANTON RD",
            "city": "STANTON",
            "state": "MI",
            "postal_code": "488888737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA RD STE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955873",
            "telephone_number": "760-381-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAAIKALA",
        "first_name": "KEALA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "urgentcaresmhd@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "12550 Hesperia Rd Ste 100",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923955873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dale William Jung, DDS
• James K Jung, D.P.M.
• Vana Marie Justice
• Juvilusan S. Salazar, M.D., Inc.
• K&C Inspire Therapy
• Simone Kain, LVN
• Leah Murugi Kairu, LVN
• Kaiser Foundation Health Plan Inc
• Senan Isabelle Kakpo-Moore, PA-C
• Azaduhi Kalaydjian, CNM, WHNP-BC

• Physician Assistant in Victorville, CA
• Providers in Victorville, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.