Individual provider Active NPI

Kelli Lynn Outlaw, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1376937516
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0085051 Issued in MD
Practice address
10 Nathan D Perlman PL
New York, NY 10003-3851
Phone
(212) 420-2000
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 324916 LA
Emergency Medicine Physician 207P00000X D0085051 MD Primary

Addresses

Primary practice location

10 Nathan D Perlman PL
New York, NY 10003-3851

Mailing address

901 Harry S Truman Dr N
Largo, MD 20774-5477
Phone (240) 461-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, LA, MD3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180612000759 DC Practitioner - Emergency Medicine 7810242021 Reassigns benefits to 3 organizations
I20210114001822 LA Practitioner - Emergency Medicine 7810242021 Reassigns benefits to 1 organization
I20230607000261 MD Practitioner - Emergency Medicine 7810242021 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Lake Emergency Group, LLC Emergency Medicine CurrentSince Dec 11, 2020 Accepting new patients
Upper Chesapeake Emergency Medicine Physicians, LLC Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
WHC Emerg Phys CurrentSince Aug 1, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince May 21, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Apr 1, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince May 21, 2024 Accepting new patients
WHC Physician Group LLC CurrentSince Aug 1, 2024 Accepting new patients
Mep Health, LLC Emergency Medicine CurrentSince May 23, 2023 Accepting new patients
Memn Hospitalists, LLC Emergency Medicine Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

15001 Health Center Dr
Bowie, MD 20716
Phone (301) 262-5511

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440

3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000

7300 Van Dusen Rd
Laurel, MD 20707
Phone (301) 725-4300

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

Organizations & group practices 11

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": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1376937516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 HARRY S TRUMAN DR N",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745477",
            "telephone_number": "240-461-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NATHAN D PERLMAN PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033851",
            "telephone_number": "212-420-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "KELLI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "324916",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0085051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.