Individual provider Active NPI

Kayla Kelly, M.D.

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1649658956
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R7502 Issued in TX
Practice address
901 W Ben White Blvd
Austin, TX 78704-6903
Phone
(512) 447-2211
NPI assigned
May 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X R7502 TX Primary

Addresses

Primary practice location

901 W Ben White Blvd
Austin, TX 78704-6903

Mailing address

901 W Ben White Blvd
Austin, TX 78704-6903
Phone (214) 797-5535

Other practice location 1

150 55th St
Brooklyn, NY 11220-2508
Phone (718) 630-7000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809004220 TX Practitioner - Internal Medicine 1759639669 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-1000

Hospital & facility affiliations

  • St David'S South Austin Medical Center Hospital, Austin, TX, CCN 450713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R7502TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Oct 1, 2018 Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Aug 15, 2018 Accepting new patients
Lonestar Pat Associates PA Internal Medicine CurrentSince Sep 29, 2020 Accepting new patients
St. David'S Healthcare Partnership, L.P., LLP Past Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

Organizations & group practices 4

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 1

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": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1649658956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W BEN WHITE BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046903",
            "telephone_number": "214-797-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W BEN WHITE BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046903",
            "telephone_number": "512-447-2211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KAYLA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R7502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.