Individual provider Active NPI

Kayla Anne Kaiser, PSY.D.

  • Psychologist
  • Myrtle Creek, OR
National Provider Identifier
1548728850
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY1203 Issued in NV
Practice address
1340 NE Lisa Way
Myrtle Creek, OR 97457
Phone
(530) 520-9213
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY1203 NV Primary

Addresses

Primary practice location

1340 NE Lisa Way
Myrtle Creek, OR 97457

Mailing address

1340 NE Lisa Way
Myrtle Creek, OR 97457-9587
Phone (530) 520-9213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014001657 NV Practitioner - Clinical Psychologist 9133651375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Psychology Associates LLCGroup PAC ID 6204180284, 15 clinicians

Practice addresses (Care Compare)

245 Mount Rose St
Reno, NV 89509-3355
Phone (775) 448-6828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY1203NVMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
G D Shoenberger, Inc. CurrentSince Sep 7, 2024 Accepting new patients
Health Psychology Associates LLC Psychologist CurrentSince Sep 7, 2024 Accepting new patients

Locations

245 Mount Rose St
Reno, NV 89509
Phone (775) 448-6828

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1548728850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 NE LISA WAY",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "974579587",
            "telephone_number": "530-520-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 NE LISA WAY",
            "city": "MYRTLE CREEK",
            "state": "OR",
            "postal_code": "97457",
            "telephone_number": "530-520-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "KAYLA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY1203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Creek, OR

Sources for this page

Verify at the official NPI Registry.