Individual provider Active NPI

Kelli K Lala, PA-C

  • Medical Physician Assistant
  • Temple, TX
National Provider Identifier
1609923341
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA06756 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-8602
Phone
(254) 724-2111
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA06756 TX Primary
Medical Physician Assistant 363AM0700X 325 MT

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-8602

Mailing address

PO Box 844658
Dallas, TX 75284-7307
Phone (254) 724-8800

Other practice location 1

810 W Highway 71
Marble Falls, TX 78654-8602
Phone (830) 201-7100

Other identifiers 1

IdentifierTypeStateIssuer
4308463MedicaidMT

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address klala14185@direct.sw.org Direct
Direct Messaging Address klala14185@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20091210000296 TX Practitioner - Physician Assistant 0941104657 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06756TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Jan 1, 2016 Accepting new patients
Eyes of Texas, LLP Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Alan D Smith MD PA Past Accepting new patients

Locations

101 E Jackson St
Burnet, TX 78611
Phone (512) 756-7510

810 W Highway 71
Marble Falls, TX 78654
Phone (830) 201-7100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: klala14185@direct.sw.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1609923341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847307",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765088602",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 W Highway 71",
            "address_purpose": "LOCATION",
            "city": "Marble Falls",
            "state": "TX",
            "postal_code": "786548602",
            "country_code": "US",
            "telephone_number": "830-201-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALA",
        "first_name": "KELLI",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06756",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "325",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4308463",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klala14185@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2401 S 31st St",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765088602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klala14185@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "810 W Highway 71",
            "city": "Marble Falls",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786548602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.