Individual provider Active NPI

Kelli Leilani Summers, MD

  • Vascular Surgery Physician
  • New Orleans, LA
National Provider Identifier
1255865242
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
330923 Issued in LA
Practice address
1542 Tulane Ave
Room 734B
New Orleans, LA 70112-2865
Phone
(504) 568-4748
Fax
(504) 568-4633
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 330923 LA Primary

Addresses

Primary practice location

1542 Tulane Ave
Room 734B
New Orleans, LA 70112-2865

Mailing address

1542 Tulane Ave FL 7
New Orleans, LA 70112-2865
Phone (719) 321-6272

Other practice location 1

200 Henry Clay Ave
New Orleans, LA 70118-5798
Phone (504) 899-9511

Other identifiers 1

IdentifierTypeStateIssuer
2445553MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220823000606 LA Practitioner - Vascular Surgery 4587934369 Reassigns benefits to 1 organization
I20240927000029 NY Practitioner - Vascular Surgery 4587934369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
State University of New York at Stony Brook, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbor View Medical Services PCGroup PAC ID 5092865873, shared by 3 NPIs, 58 clinicians

Practice addresses (Care Compare)

4 Technology Dr
Suite 120
East Setauket, NY 11733-4068
Phone (631) 246-8289

Hospital & facility affiliations

  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246

Merit-based Incentive Payment System (MIPS)

Final score
94.21 of 100Reported as group
Quality
81.06
Promoting interoperability
100
Improvement activities
40
Cost
71.94

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal27
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Aug 1, 2022 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Current Accepting new patients
Harbor View Medical Services PC CurrentSince Aug 21, 2024 Accepting new patients
Harbor View Medical Services PC Current Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Aug 1, 2022 Accepting new patients
Harbor View Medical Services PC Vascular Surgery CurrentSince Aug 21, 2024 Accepting new patients

Locations

478 S Johnson St
Fl 6
New Orleans, LA 70112
Phone (504) 412-1819

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

1542 Tulane Ave
Fl 7
New Orleans, LA 70112
Phone (504) 568-4080

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

1542 Tulane Ave
Rm 734B
New Orleans, LA 70112
Phone (401) 919-0355

4 Technology Dr
Ste 120
East Setauket, NY 11733
Phone (516) 246-8289

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

75 N Country Rd
Ste 201
Prt Jefferson, NY 11777
Phone (631) 686-2575

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1255865242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 TULANE AVE FL 7",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122865",
            "telephone_number": "719-321-6272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 TULANE AVE",
            "address_2": "ROOM 734B",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122865",
            "telephone_number": "504-568-4748",
            "fax_number": "504-568-4633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Henry Clay Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701185798",
            "country_code": "US",
            "telephone_number": "504-899-9511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "KELLI",
        "middle_name": "LEILANI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "LA",
            "license": "330923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2445553",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.