Active NPI
Kelly Pickering, PA-C
- Physician Assistant
- Glendale, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA61791
- Practice address
- 1500 E Chevy Chase Dr Ste 401
Glendale, CA 91206-4191 - Phone
- (818) 863-4444
- NPI assigned
- Jan 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA61791 | CA | Primary |
Addresses
Primary practice location
1500 E Chevy Chase Dr Ste 401
Glendale, CA 91206-4191
Mailing address
1500 E Chevy Chase Dr Ste 401
Glendale, CA 91206-4191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 E Chevy Chase Dr
Suite 201
Glendale, CA 91206-4199
Phone (818) 863-4099
1500 E Chevy Chase Dr
Suite 401
Glendale, CA 91206-4191
Phone (818) 863-4446
1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.77 of 100
- Quality
- 81.54
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.77 of 100
- Quality
- 78.77
- Promoting interoperability
- 92
- Improvement activities
- 40
- Cost
- 48
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61791 | CA | MD | Dentist |
| PA61791 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current | Accepting new patients | |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| Adventist Health Physicians Network | Current | Accepting new patients |
Locations
1500 E Chevy Chase Dr
Ste 201
Glendale, CA 91206
Phone (818) 863-4099
1500 E Chevy Chase Dr
Ste 401
Glendale, CA 91206
Phone (818) 863-4444
1700 E Cesar E Chavez Ave
Ste 3300
Los Angeles, CA 90033
Phone (323) 264-2132
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175
9650 Gross Point Rd
Ste 2900
Skokie, IL 60076
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 7
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.
-
dba Adventist Health Glendale
- General Acute Care Hospital
- Glendale, CA
- NPI 1831188275
-
- Family Medicine Physician
- Glendale, CA
- NPI 1083976294
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1215927470
-
dba NorthShore University HealthSystem Faculty Practice Associates
- Emergency Medicine Physician
- Evanston, IL
- NPI 1497701882
-
- Physical Therapy Clinic/Center
- Paradise, CA
- NPI 1134092190
-
- Endocrinology, Diabetes & Metabolism Physician
- La Canada Flintridge, CA
- NPI 1427310648
-
dba NorthShore Anesthesia Group
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Adventist Health Glendale
- General Acute Care Hospital
- Glendale, CA
- NPI 1831188275
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721174400000",
"number": "1497219380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E CHEVY CHASE DR STE 401",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E CHEVY CHASE DR STE 401",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912064191",
"telephone_number": "818-863-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICKERING",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-25",
"last_updated": "2024-07-17",
"certification_date": "2024-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA61791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.