Individual provider Active NPI

Kayla Cook Haywood, PA-C

  • Physician Assistant
  • Oak Harbor, WA
National Provider Identifier
1376198101
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18360 Issued in TX
Practice address
165 SE Ely St
Oak Harbor, WA 98277-3748
Phone
(210) 393-7675
NPI assigned
Aug 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 61128920 WA
Physician Assistant 363A00000X PA18360 TX Primary

Addresses

Primary practice location

165 SE Ely St
Oak Harbor, WA 98277-3748

Mailing address

165 SE Ely St
Oak Harbor, WA 98277-3748

Other names 1

  • Kayla Nicole Cook Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210802001956 WA Practitioner - Physician Assistant 6406250240 Reassigns benefits to 1 organization
I20251030001809 TX Practitioner - Physician Assistant 6406250240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Texas Tech University Health Science Center School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Dermatology PLLCGroup PAC ID 6305092859, 12 clinicians

Practice addresses (Care Compare)

400 Enterprise Blvd BLDG
Suite 2
Corpus Christi, TX 78411
Phone (361) 882-5560

Merit-based Incentive Payment System (MIPS)

Final score
79.33 of 100Reported as group
Quality
74.17
Improvement activities
40
Cost
65.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA18360TXMDPhysician Assistant
61128920WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Dermatology PLLC CurrentSince Oct 1, 2025 Accepting new patients
Wellmed Medical Group, PA PastSince Oct 1, 2025 Accepting new patients

Locations

4141 S Staples St
Ste 300
Corpus Christi, TX 78411
Phone (361) 882-5560

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1376198101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SE ELY ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 SE ELY ST",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982773748",
            "telephone_number": "210-393-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "KAYLA",
        "middle_name": "COOK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61128920",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "COOK",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Harbor, WA

Sources for this page

Verify at the official NPI Registry.