Individual provider Active NPI

Kellie Jean Klein, PA-C

  • Physician Assistant
  • Pasadena, CA
National Provider Identifier
1619580461
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64998 Issued in CA
Practice address
800 Fairmount Ave Ste 323
Pasadena, CA 91105-3155
Phone
(213) 334-4111
Fax
(213) 335-5001
NPI assigned
Aug 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 64998 CA Primary

Addresses

Primary practice location

800 Fairmount Ave Ste 323
Pasadena, CA 91105-3155

Mailing address

800 Fairmount Ave Ste 323
Pasadena, CA 91105-3155
Phone (213) 334-4111

Other practice location 1

100 W California Blvd
Pasadena, CA 91105-3010
Phone (213) 334-4111

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409002972 CA Practitioner - Physician Assistant 5496166639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpha Hormones IncGroup PAC ID 8921428046, 5 clinicians

Practice addresses (Care Compare)

800 Fairmount Ave
Suite 323
Pasadena, CA 91105-3155
Phone (213) 334-4111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8167AZMDPharmacist
64998CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Reproductive Institute, PLLC PastSince Aug 1, 2021 Accepting new patients

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": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1619580461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE STE 323",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053155",
            "telephone_number": "213-334-4111",
            "fax_number": "213-335-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE STE 323",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053155",
            "telephone_number": "213-334-4111",
            "fax_number": "213-335-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W California Blvd",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053010",
            "country_code": "US",
            "telephone_number": "213-334-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "KELLIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-30",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.