Kelada Physicians Group, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

KELADA PHYSICIANS GROUP, INC

Doing business as

Roseville Family Healthcare

Practice address

680 Sunrise Ave
Roseville, CA 95661-4110

Phone

(916) 786-4700

Fax

(916) 786-3912

NPI assigned

Sep 3, 2019

Organization subpart

No

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

Authorized official

Name

John Paul Youssry Kelada, MDNPI 1013396118

Title

Vice President/Secretary

Phone

(916) 786-4700

Specialties & licenses 1

Addresses

Other names 1

• Roseville Family Healthcare Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Paul Youssry Kelada, MD

  • Family Medicine Physician
  • Roseville, CA
  • NPI 1013396118
  Medicare reassignment Care Compare group NPD Authorized official
• Alexandramary Kelada, DO, MPH

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1811429418
  Medicare reassignment Care Compare group NPD
• Youssry J Kelada, M.D.

  • Family Medicine Physician
  • Roseville, CA
  • NPI 1316919442
  Medicare reassignment Care Compare group NPD
• Roxzy R. Ruelle, PA

  • Physician Assistant
  • Roseville, CA
  • NPI 1205231065
  Medicare reassignment

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1437707387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614110",
            "telephone_number": "916-786-4700",
            "fax_number": "916-786-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614110",
            "telephone_number": "916-786-4700",
            "fax_number": "916-786-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELADA PHYSICIANS GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "KELADA",
        "authorized_official_first_name": "JOHN PAUL",
        "authorized_official_middle_name": "YOUSSRY",
        "authorized_official_title_or_position": "VICE PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "916-786-4700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jkelada43733@hpmg.direct-ci.net",
            "affiliation": "N",
            "endpointDescription": "URL for MyHillChart Epic",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Epic",
            "address_1": "680 Sunrise Ave",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956614110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Roseville Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Keelor, RRT
• Claudette Keene
• Joshua M. Kehoe, MD
• Joseph Zachary Kehrt, MD MS
• Bradley Keizer, CRNA
• Alexandramary Kelada, DO, MPH
• Andrew Kelada, M.D.
• Anthony Kelada, M.D.
• John Paul Youssry Kelada, MD
• Youssry J Kelada, M.D.

• Primary Care Clinic/Center in Roseville, CA
• Providers in Roseville, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.