NPIMap

Individual provider Active NPI

Kylan Poullard

  • Physician Assistant
  • Alexandria, LA
National Provider Identifier
1780268516
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
327294 Issued in LA
Practice address
3311 Prescott Rd Ste 415
Alexandria, LA 71301-3985
Phone
(318) 528-4455
Fax
(318) 528-4466
NPI assigned
May 7, 2021
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 327294 LA Primary

Addresses

Primary practice location

3311 Prescott Rd Ste 415
Alexandria, LA 71301-3985

Mailing address

231 Windermere Blvd
Alexandria, LA 71303-3538

Other practice location 1

231 Windermere Blvd
Alexandria, LA 71303-3538
Phone (318) 487-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210813001053 LA Practitioner - Physician Assistant 1759785660 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians
DM Properties of Lafayette, LLCGroup PAC ID 8527292986, 16 clinicians

Practice addresses (Care Compare)

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105-6800
Phone (318) 681-4138

2705 Hwy 28 E
Pineville, LA 71360-5712
Phone (318) 704-6770

3311 Prescott Rd
Alexandria, LA 71301-3900
Phone (318) 487-1122

3601 Jackson St Ext
Alexandria, LA 71303-3002

3601 Jackson St Extension
Alexandria, LA 71303-3002
Phone (318) 787-6877

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.92 of 100Reported as group
Quality
78.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Eye and Laser Center, LLC CurrentSince Jul 12, 2021 Accepting new patients
Calcasieu Urgent Care, LLC CurrentSince May 19, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 2, 2024 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince May 19, 2022 Accepting new patients
Alexandria Eye and Laser Center, LLC CurrentSince Jul 12, 2021 Accepting new patients
DM Properties of Lafayette, LLC CurrentSince Jun 23, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 2, 2024 Accepting new patients
Natchitoches Parkway Imaging, LLC PastSince Oct 15, 2023 Accepting new patients

Locations

231 Windermere Blvd
Alexandria, LA 71303
Phone (318) 445-7770

3311 Prescott Rd
Ste 415
Alexandria, LA 71301
Phone (318) 443-9300

3601 Jackson Street Ext
Alexandria, LA 71303
Phone (318) 787-6877

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

1008 S 6th St
Leesville, LA 71446
Phone (337) 392-1994

65 Medical Park Blvd
Pineville, LA 71360
Phone (318) 445-6363

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

3439 Highway 1256
Sulphur, LA 70665
Phone (337) 607-0037

Interoperability endpoints

  • Direct secure messaging: kpoullard@laeye.emadirect.md
  • Direct secure messaging: kpoullard428773@christushealth.direct-ci.net

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 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1780268516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD STE 415",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013985",
            "telephone_number": "318-528-4455",
            "fax_number": "318-528-4466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 Windermere Blvd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713033538",
            "country_code": "US",
            "telephone_number": "318-487-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POULLARD",
        "first_name": "KYLAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "327294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.