NPIMap

Individual provider Active NPI

Kelley Michele Scott, MD

  • Internal Medicine Physician
  • Emeryville, CA
National Provider Identifier
1477972438
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A140882 Issued in CA
Practice address
5800 Hollis St
Emeryville, CA 94608-2016
Phone
(888) 924-1036
NPI assigned
Apr 7, 2014
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A140882 CA Primary

Addresses

Primary practice location

5800 Hollis St
Emeryville, CA 94608-2016

Mailing address

5800 Hollis St
Emeryville, CA 94608-2016
Phone (888) 924-1036

Other practice location 1

12702 N Ih 35
Live Oak, TX 78233-2609
Phone (210) 650-9669

Other identifiers 2

IdentifierTypeStateIssuer
A140882OtherCASTATE MEDICAL LICENSE
KS3232267556MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171102002255 CA Practitioner - Internal Medicine 7012273378 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

1300 Crane St
Menlo Park, CA 94025-4260
Phone (650) 498-6500

4725 1St St
Suite 100
Pleasanton, CA 94566-7366
Phone (925) 462-7060

6121 Hollis St
Emeryville, CA 94608-2077

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A140882CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care Internal Medicine CurrentSince Oct 10, 2022 Accepting new patients
Stanford Health Care Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 18, 2017 Accepting new patients
Stanford Health Care CurrentSince Oct 10, 2022 Accepting new patients
University Healthcare Alliance Internal Medicine CurrentSince Oct 10, 2022 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Sep 18, 2017 Accepting new patients
Affinity Medical Group Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

5800 Hollis St
Emeryville, CA 94608
Phone (510) 806-2100

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: kelley.scott@hca7.eclinicaldirectplus.com

Organizations & group practices 8

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1477972438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 HOLLIS ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082016",
            "telephone_number": "888-924-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 HOLLIS ST",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082016",
            "telephone_number": "888-924-1036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12702 N Ih 35",
            "address_purpose": "LOCATION",
            "city": "Live Oak",
            "state": "TX",
            "postal_code": "782332609",
            "country_code": "US",
            "telephone_number": "210-650-9669",
            "fax_number": "210-654-1432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KELLEY",
        "middle_name": "MICHELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A140882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "A140882",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KS3232267556",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.