NPIMap

Individual provider Active NPI

Kayla Nacarelli, PA-C

  • Medical Physician Assistant
  • Charleston, SC
National Provider Identifier
1699171694
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2406 Issued in SC
Practice address
25 Courtenay Dr
Charleston, SC 29425-3030
Phone
(843) 792-1414
NPI assigned
Nov 18, 2014
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00784 RI
Physician Assistant 363A00000X PA2406 SC
Medical Physician Assistant 363AM0700X PA2406 SC Primary

Addresses

Primary practice location

25 Courtenay Dr
Charleston, SC 29425-3030

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-1414

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150324000536 RI Practitioner - Physician Assistant 2668799057 Reassigns benefits to 1 organization
I20170404000943 SC Practitioner - Physician Assistant 2668799057 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

167 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

2060 Sam Rittenberg Blvd
Charleston, SC 29407-4616
Phone (843) 792-1414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA00784RIMDPhysician Assistant
PA2406SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean State Urgent Care Center of Woonsocket CurrentSince Jan 30, 2015 Accepting new patients
Roper Hospital Inc. CurrentSince Jan 1, 2018 Accepting new patients
Roper Hospital Inc CurrentSince Jan 1, 2018 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Oct 13, 2020 Accepting new patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Oct 13, 2020 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Jan 1, 2018 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince May 15, 2024 Accepting new patients

Locations

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

25 John a Cummings Way
Woonsocket, RI 02895
Phone (401) 235-7310

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

Interoperability endpoints

  • Direct secure messaging: kdecristofano224614@direct.musc.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1699171694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COURTENAY DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294253030",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACARELLI",
        "first_name": "KAYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00784",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA2406",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "PA2406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "171 Ashley Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294250100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.