Individual provider Active NPI

Janelle Marie Kalle, PA-C

  • Medical Physician Assistant
  • Brandon, FL
National Provider Identifier
1811998156
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105959 Issued in FL
Practice address
500 Vonderburg Dr
102
Brandon, FL 33511-5964
Phone
(813) 386-2547
Fax
(813) 681-5250
NPI assigned
Aug 9, 2005
Last updated
May 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105959 FL Primary

Addresses

Primary practice location

500 Vonderburg Dr
102
Brandon, FL 33511-5964

Mailing address

500 Vonderburg Dr
102
Brandon, FL 33511-5964
Phone (813) 386-2547

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130606000547 FL Practitioner - Physician Assistant 6507815255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manatee Senior CareGroup PAC ID 7911328273, 8 clinicians

Practice addresses (Care Compare)

4112 53Rd Ave E
Suite 20478
Bradenton, FL 34203-5512
Phone (800) 605-3182

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105959FLMDMedical Physician Assistant

Organizations & group practices 1

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 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1811998156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR",
            "address_2": "102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115964",
            "telephone_number": "813-386-2547",
            "fax_number": "813-681-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VONDERBURG DR",
            "address_2": "102",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115964",
            "telephone_number": "813-386-2547",
            "fax_number": "813-681-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLE",
        "first_name": "JANELLE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.