Kristyn Tallo, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

363A00000X Issued in LA

Practice address

42421 Pelican Professional Park
Hammond, LA 70403-2405

Phone

(985) 400-5551

NPI assigned

Jun 9, 2025

Sex

Female

Sole proprietor

No

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 LA

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

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soine Medical Enterprises, LLCGroup PAC ID 0840434205, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Soine Medical Enterprises, LLC

  dba Soine Dermatology and Aesthetics

  • Dermatology Physician
  • Covington, LA
  • NPI 1871928051
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1437044823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23154 WATERBUCK LAKE CT",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707267475",
            "telephone_number": "225-810-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42421 PELICAN PROFESSIONAL PARK",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704032405",
            "telephone_number": "985-400-5551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 Ochsner Blvd",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704338110",
            "country_code": "US",
            "telephone_number": "985-400-5551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLO",
        "first_name": "KRISTYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "363A00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip James Swanson
• Tosha Adele Swink, LOTR
• Synergy Home Care Northshore Region Inc (CenterWell Home Health)
• T Matthews Transportation
• Sade Talley
• Tasha Linn Tambeau
• Tangi Cares, LLC (Home Instead Senior Care)
• Tangi Wellness & Health
• Tangipahoa Charter School Association (Tangi Academy)
• Georges Elie Tanios, MD

• Dermatology Physician in Hammond, LA
• Providers in Hammond, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.