Kelly Rutherford S. Hall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13266 Issued in CA

Practice address

227 W Janss Rd Ste 340
Thousand Oaks, CA 91360-1879

Phone

(805) 852-9100

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden State Providers, a Medical CorporationGroup PAC ID 7012212475, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.hall@hca3.eclinicaldirectplus.com

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.

• Golden State Providers, a Medical Corporation

  • Multi-Specialty Clinic/Center
  • Moorpark, CA
  • NPI 1366859449
  Medicare reassignment Care Compare group
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Dignity Health

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  NPD (past)
• Los Robles Regional Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1033163019
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Los Robles Regional Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1306890389
  Care Compare affiliation

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1710989439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W JANSS RD STE 340",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601879",
            "telephone_number": "805-852-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W JANSS RD STE 340",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601879",
            "telephone_number": "805-852-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "KELLY",
        "middle_name": "RUTHERFORD S.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13266",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA13266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gaith Ghassan Haidar
• Jawad Haider, MD
• Nilofar Natalie Hajian, PHARMD, MBA
• Joelle Jean Hajj
• Hal M. Weitzbuch, M.D. Medical Corporation
• Yeranuhi Yera Hambardzumyan
• Kaydee Elizabeth Hamer
• John S Hamilton, R.N.
• Stacy Jo Hamlet, O.D.
• Aimee L Hammond, RD

• Physician Assistant in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.
• 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.