Kelli Gora

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95000429 Issued in CA

Practice address

41870 Garstin Rd.
Big Bear Lake, CA 92315

Phone

(909) 878-8294

NPI assigned

Mar 4, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bear Valley Community Health Care DistrictGroup PAC ID 0345138582, 28 clinicians

Elevate Emergency MedicineGroup PAC ID 8325580707, 21 clinicians

Big Bear Urgent Care IncGroup PAC ID 8729460233, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bear Valley Community Health Care District

  dba Bear Valley Community Hospital

  • Long Term Care Pharmacy
  • Big Bear Lake, CA
  • NPI 1073553756
  Medicare reassignment Care Compare group NPD
• Big Bear Urgent Care Inc

  • Urgent Care Clinic/Center
  • Big Bear Lake, CA
  • NPI 1366104671
  Medicare reassignment Care Compare group NPD
• Elevate Emergency Medicine

  • Emergency Medicine Physician
  • Big Bear Lake, CA
  • NPI 1457118705
  Medicare reassignment Care Compare group NPD
• Stephen R Shea, M.D., Inc

  • Emergency Medicine Physician
  • San Pedro, CA
  • NPI 1942239033
  Medicare reassignment NPD
• Stephen R. Shea, M.D., Inc.

  dba Long Beach Emergency Medical Group

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1326079872
  NPD

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

• Bear Valley Community Health Care District

  dba Bear Valley Community Hospital

  • 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": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1417372186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 LA LOMA DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927052902",
            "telephone_number": "714-335-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41870 GARSTIN RD.",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "92315",
            "telephone_number": "909-878-8294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORA",
        "first_name": "KELLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95000429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fuquan Gao
• Angeleke Garcia
• Garfield Beach CVS LLC (CVS Pharmacy #09739)
• Harry David Goldwasser, MD
• Gabino A Gomez-Canul
• Sara Gordon
• Patrick David Griffiths, MFT
• Jessica Lynn Grow
• Allison Harker
• Tamie S Harris

• Nurse Practitioner in Big Bear Lake, CA
• Providers in Big Bear Lake, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.