Kaylene Larissa Millard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0009459 Issued in MD

Practice address

5530 Wisconsin Ave Ste 850
Chevy Chase, MD 20815-4446

Phone

(301) 869-9776

NPI assigned

Jun 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

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

Wake Forest University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Primary Care and Associates LLCGroup PAC ID 5092991984, 167 clinicians

Suburban/NRH Medical Rehabilitation IncGroup PAC ID 6507846771, 885 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kaylene.millard@cpcl.eclinicaldirectplus.com

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.

• Comprehensive Primary Care and Associates LLC

  dba CloseKnit

  • Internal Medicine Physician
  • Rockville, MD
  • NPI 1831492586

  DC

  Medicare reassignment Care Compare group
• Suburban/NRH Medical Rehabilitation Inc

  dba NRH Rehabilitation Network at Bethesda

  • Rehabilitation Clinic/Center
  • Bethesda, MD
  • NPI 1457354748
  Care Compare group
• Bimc Faculty Practice

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1538351572

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1477815017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15825 SHADY GROVE RD STE 140",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504015",
            "telephone_number": "301-869-9776",
            "fax_number": "301-417-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE STE 850",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154446",
            "telephone_number": "301-869-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLARD",
        "first_name": "KAYLENE",
        "middle_name": "LARISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009459",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001003569",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0170981",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA200001994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC7007A",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9667",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Michael
• Jordan Mickens
• Midatlantic ENT
• Miknowski Medical Practice
• Wendell G Miles
• Miller Eye Care Center, LLC (My Eye Dr.)
• Elizabeth A. Miller, M.S.W.
• Jamie S Miller, PT
• Mark A Miller
• Rebecca Mills, LMT

• Physician Assistant in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.