Kelly Lynne Killeen, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A92060 Issued in CA

Practice address

436 N Bedford Dr Ste 103
Beverly Hills, CA 90210-4323

Phone

(310) 278-8200

Fax

(310) 278-8230

NPI assigned

Mar 12, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 26, 2019 through Apr 26, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1699807065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR STE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104323",
            "telephone_number": "310-278-8200",
            "fax_number": "310-278-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N BEDFORD DR STE 103",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104323",
            "telephone_number": "310-278-8200",
            "fax_number": "310-278-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "KELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A92060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoine Kenneth Khoury, DO
• Sepideh Kiani
• Christie Kay Kidd, PA C
• Dana Kiesel, PHD
• Kiki L. Hurt MD Anesthesia and Intensivist PC
• Alexander Kim, MD
• Andrew-Sunjun Kim, DDS
• Ashley Kim
• Chae Kim
• Changkyu Kim

• Plastic Surgery Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.