Kelly Kathleen Balletti

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9110317 Issued in FL

Practice address

3275 Ponce de Leon Blvd
Coral Gables, FL 33134-7251

Phone

(305) 461-2000

Fax

(786) 228-4035

NPI assigned

Apr 7, 2017

Last updated

Oct 2, 2026By 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

Enrolled in FL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alysa R. Herman, MD, PAGroup PAC ID 0749717346, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Alysa R. Herman, MD, PA

  • MOHS-Micrographic Surgery Physician
  • Coral Gables, FL
  • NPI 1669293122
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1790218634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3275 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331347251",
            "telephone_number": "305-461-2000",
            "fax_number": "786-228-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3275 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331347251",
            "telephone_number": "305-461-2000",
            "fax_number": "786-228-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLETTI",
        "first_name": "KELLY",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9110317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilio H. Balius, O.D.
• Brittney Ball, BEHAVIOR TECHNICIAN
• Delma M Balladares
• Lynda Nicole Ballestas
• David Alexander Balletti
• Michael A Balsamo
• Yasmin Balzan
• Banyan Community Health Center, Inc. (Banyan Health Systems Inc)
• Banyan Community Health Center, Inc.
• Banyan Community Health Center, Inc. (Banyan Health Systems, Inc.)

• Medical Physician Assistant in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.