Individual provider Active NPI

Alexandramary Kelada, DO, MPH

  • Internal Medicine Physician
  • Roseville, CA
National Provider Identifier
1811429418
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18267 Issued in CA
Practice address
680 Sunrise Ave
Roseville, CA 95661-4110
Phone
(916) 786-4700
Fax
(916) 786-3912
NPI assigned
Apr 2, 2017
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18267 CA Primary

Addresses

Primary practice location

680 Sunrise Ave
Roseville, CA 95661-4110

Mailing address

680 Sunrise Ave
Roseville, CA 95661-4110
Phone (916) 786-4700

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200710001703 CA Practitioner - Internal Medicine 5294006656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kelada Physicians Group IncGroup PAC ID 9638401144, 3 clinicians

Practice addresses (Care Compare)

680 Sunrise Ave
Roseville, CA 95661-4110
Phone (916) 786-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
18267CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelada Physicians Group, Inc CurrentSince Sep 1, 2020 Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

680 Sunrise Ave
Roseville, CA 95661
Phone (916) 521-6419

Interoperability endpoints

  • Direct secure messaging: akelada118693@hpmg.direct-ci.net

Organizations & group practices 3

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1811429418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614110",
            "telephone_number": "916-786-4700",
            "fax_number": "916-786-3912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 SUNRISE AVE",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614110",
            "telephone_number": "916-786-4700",
            "fax_number": "916-786-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELADA",
        "first_name": "ALEXANDRAMARY",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-02",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "18267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.