Individual provider Active NPI

Kendall Marie Carlis

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1639844459
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-152636 Issued in AL
Practice address
800 Lakeshore Dr
Birmingham, AL 35229-0002
Phone
(205) 726-2401
NPI assigned
Aug 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-152636 AL
Certified Registered Nurse Anesthetist 367500000X 1-152636 AL Primary

Addresses

Primary practice location

800 Lakeshore Dr
Birmingham, AL 35229-0002

Mailing address

800 Lakeshore Dr
Birmingham, AL 35229-0002
Phone (205) 726-2401

Other practice location 1

85 Herrick St
Beverly, MA 01915-1790
Phone (978) 816-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230808000830 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537521521 Reassigns benefits to 1 organization
I20240805000258 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537521521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians
Anesthesiologists Associated PCGroup PAC ID 6204739519, 418 clinicians

Practice addresses (Care Compare)

21 Eastern Ave
Worcester, MA 01605-3094
Phone (508) 856-2500

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923-4065
Phone (978) 304-8451

701 Princeton Ave SW
Birmingham, AL 35211-1303
Phone (205) 848-2925

85 Herrick St
Beverly, MA 01915-1790
Phone (978) 816-3700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-152636ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jun 1, 2025 Accepting new patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered CurrentSince Jul 13, 2023 Accepting new patients
Anesthesiologists Associated PC CurrentSince Jul 13, 2023 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jun 1, 2025 Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

21 Eastern Ave
Worcester, MA 01605
Phone (508) 334-8419

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

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 4

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": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1639844459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 LAKESHORE DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352290002",
            "telephone_number": "205-726-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 LAKESHORE DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352290002",
            "telephone_number": "205-726-2401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Herrick St",
            "address_purpose": "LOCATION",
            "city": "Beverly",
            "state": "MA",
            "postal_code": "019151790",
            "country_code": "US",
            "telephone_number": "978-816-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLIS",
        "first_name": "KENDALL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-152636",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-152636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.