Individual provider Active NPI

Kathleen Ann Holoyda

  • Plastic Surgery Physician
  • South Lake Tahoe, CA
National Provider Identifier
1427348473
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A129448 Issued in CA
Practice address
2175 South Ave
South Lake Tahoe, CA 96150-7024
Phone
(530) 543-5799
Fax
(530) 542-2872
NPI assigned
Apr 11, 2011
Last updated
Dec 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A129448 CA Primary
Plastic Surgery Physician 208200000X 21257 NV

Addresses

Primary practice location

2175 South Ave
South Lake Tahoe, CA 96150-7024

Mailing address

2170 South Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 541-3420

Other practice location 1

925 Tahoe Blvd Ste 105
Incline Village, NV 89451-7498
Phone (530) 543-5799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 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
I20210824001804 CA Practitioner - Plastic and Reconstructive Surgery 3476785734 Reassigns benefits to 2 organizations
I20251028004273 NV Practitioner - Plastic and Reconstructive Surgery 3476785734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Wisconsin School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

1139 3Rd St
South Lake Tahoe, CA 96150-3465
Phone (530) 543-5691

2170 S Ave
South Lake Tahoe, CA 96150-7026

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.42 of 100Reported as group
Quality
93.48
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy16
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision11
Removal of tissue23
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A129448CAMDPlastic Surgery Physician
21257NVMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tahoe Carson Valley Medical Group Inc CurrentSince Aug 1, 2021 Accepting new patients
Barton Medical Foundation CurrentSince Jan 17, 2023 Accepting new patients
Barton Healthcare System Past Accepting new patients

Locations

1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660

1139 3rd St
South Lake Tahoe, CA 96150
Phone (530) 541-3100

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

2175 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5711

Interoperability endpoints

  • Direct secure messaging: kholoyda172390@direct.renown.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1427348473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-541-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507024",
            "telephone_number": "530-543-5799",
            "fax_number": "530-542-2872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Tahoe Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Incline Village",
            "state": "NV",
            "postal_code": "894517498",
            "country_code": "US",
            "telephone_number": "530-543-5799",
            "fax_number": "530-542-2872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLOYDA",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A129448",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NV",
            "license": "21257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.