Active NPI
Kelly Lu, PA-C
- Physician Assistant
- Santa Clara, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA57572
- Practice address
- 2734 El Camino Real
Santa Clara, CA 95051-3007 - Phone
- (408) 241-3801
- NPI assigned
- Oct 1, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | PA57572 | CA | Primary |
Addresses
Primary practice location
2734 El Camino Real
Santa Clara, CA 95051-3007
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2441 Mission College Blvd
Santa Clara, CA 95054-1214
Phone (800) 478-8837
2734 El Camino Real
Santa Clara, CA 95051-3007
Phone (408) 241-3801
370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA57572 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter East Bay Medical Foundation | Past | Accepting new patients |
Locations
18400 US Highway 18
Apple Valley, CA 92307
Phone (760) 810-7590
1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100
1189 E Herndon Ave
Ste 103
Fresno, CA 93720
Phone (559) 450-7777
370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200
325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
101 Rowland Way
Ste 220
Novato, CA 94945
Phone (415) 878-7200
795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832
1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911
3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847
123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200
2734 El Camino Real
Santa Clara, CA 95051
Phone (408) 241-3801
3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750
10200 Trinity Pkwy
Ste 101
Stockton, CA 95219
Phone (209) 323-3488
550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865
Interoperability endpoints
- klu583305@hisp.ehr.sutterhealth.org
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
-
- Clinical Medical Laboratory
- Santa Clara, CA
- NPI 1669287033
-
- Family Medicine Physician
- Orinda, CA
- NPI 1871538769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627430400000",
"number": "1548801459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 DISTEL CIR",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940221408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2734 EL CAMINO REAL",
"city": "SANTA CLARA",
"state": "CA",
"postal_code": "950513007",
"telephone_number": "408-241-3801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LU",
"first_name": "KELLY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-01",
"last_updated": "2021-07-28",
"certification_date": "2021-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA57572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Clara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.