Kelli Marie Rose, M.D.
Individual provider Active NPI Allergy & Immunology Physician · San Luis Obispo, CA
NPI 1407028798 · NPPES record last updated Oct 17, 2023
Key facts
- NPI
- 1407028798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy & Immunology Physician 207K00000X
- License
- A134727 (CA)
- Practice address
- 1551 Bishop St
Suite 520
San Luis Obispo, CA 93401-4635 - Phone
- (805) 543-2744
- Fax
- (805) 543-0539
- NPI assigned
- Mar 27, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Allergy/Immunology
- Education
- Medical College of Wisconsin, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allergy Partners of California Inc
Practice addresses (Care Compare)
1551 Bishop St
Suite 220
San Luis Obispo, CA 93401-4661
Phone (805) 543-2744
Hospital & facility affiliations
- Marian Regional Medical Center
- French Hospital Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150706000604 | CA | Practitioner - Allergy/Immunology | 0042497398 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A134727 | CA | MD | Allergy & Immunology Physician |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allergy Partners of California, Inc. | Allergy & Immunology | Current |
Accepting new patients |
| Allergy Partners of California, Inc. | Allergy & Immunology | Current |
Accepting new patients |
Locations
320 James Way
Ste 240
Pismo Beach, CA 93449
Phone (805) 574-1850
821 E Chapel St
Ste 201
Santa Maria, CA 93454
Phone (805) 922-5746
1551 Bishop St
Ste 520
Sn Luis Obisp, CA 93401
Phone (805) 461-5212
1551 Bishop St
Ste 220
Sn Luis Obisp, CA 93401
Phone (805) 541-0668
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | A134727 | CA | Yes |
Addresses
Primary practice location
1551 Bishop St
Suite 520
San Luis Obispo, CA 93401-4635
Mailing address
PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CB235871 | Other | CA | MEDICARE PTAN |
| 1407028798 | Medicaid | CA |
Other names
- Kelli Marie Pellmann
Other providers in San Luis Obispo, CA
- Casey Roos
- Fatima Saray Rosas Maldonado
- Nettie M Rosburg
- Amy Annette Rose
- Carter Rose
- Diane Carrie Rosenblatt
- Jennie Roski
- Philip Roski
- Thomas M Rosplock
- Danielle Ross
All providers in San Luis Obispo, CA · Allergy & Immunology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.