Organization Active NPI

KP Medical Associates PLLC

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1770115487
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
KP MEDICAL ASSOCIATES PLLC
Doing business as
Calla Women's Health
Practice address
162 E 78TH St FL 3
New York, NY 10075-0406
Phone
(646) 450-9029
NPI assigned
Feb 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Authorized official

Name
Dr. Kameelah A. Phillips, MDNPI 1891999686
Title
Owner
Phone
(332) 217-0335

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

162 E 78TH St FL 3
New York, NY 10075-0406

Mailing address

162 E 78TH St FL 3
New York, NY 10075-0406
Phone (332) 217-0335

Other names 1

  • Calla Women's Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200812003117 NY Part B Supplier - Clinic/Group Practice 6305262064 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

162 E 78th St
Fl 3
New York, NY 10075
Phone (212) 879-1717

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1770115487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 E 78TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750406",
            "telephone_number": "332-217-0335",
            "fax_number": "332-217-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 E 78TH ST FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750406",
            "telephone_number": "646-450-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KP MEDICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KAMEELAH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "332-217-0335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calla Women's Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Calla Women's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.