Kayla Elliott, PA-C
Individual provider Active NPI Medical Physician Assistant · Goldendale, WA
NPI 1699175240 · NPPES record last updated Aug 19, 2016
Key facts
- NPI
- 1699175240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA60567480 (WA)
- Practice address
- 317 Sanders Way
Goldendale, WA 98620-9059 - Phone
- (509) 773-4017
- NPI assigned
- Sep 2, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Klickitat County Public Hospital District No 1
Practice addresses (Care Compare)
317 Sanders Way
Goldendale, WA 98620-9059
Phone (509) 773-4017
Hospital & facility affiliations
- Adventist Health Home Care
- Providence Home Health
- Klickitat Valley Hospital
- Mid-Columbia Medical Center
- Providence Hood River Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170103000824 | WA | Practitioner - Physician Assistant | 5890917405 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA057105 | PA | MD | Medical Physician Assistant |
| PA60567480 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Klickitat County Public Hospital District No 1 | Current |
Accepting new patients | |
| Dr. Majeed'S Health PLLC | Past |
Accepting new patients | |
| Klickitat County Public Hospital District No 1 | Past | Accepting new patients |
Locations
317 Sanders Way
Goldendale, WA 98620
Phone (509) 773-4017
310 S Roosevelt St
Goldendale, WA 98620
Phone (509) 486-2151
Interoperability endpoints
- kelliott@kvhealthfm.gwaydirect.com
- https://api.platform.athenahealth.com/23148/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA057105 | PA | |
| Medical Physician Assistant | 363AM0700X | PA60567480 | WA | Yes |
Addresses
Primary practice location
317 Sanders Way
Goldendale, WA 98620-9059
Mailing address
317 Sanders Way
Goldendale, WA 98620-9059
Phone (509) 773-4017
Other names
- Kayla Janis
Other providers in Goldendale, WA
- Shalea Daniels
- David and Brenda Reimche-Vu, DDS, PS
- Jennifer Denning
- Edge Medical Services
- Jacqueline Nicole Eide
- Lyle Edward Ferch
- Shawna Fletcher
- Michaela Rylee Frost
- Kailey Fry
- Rob Garner
All providers in Goldendale, WA · Medical Physician Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.