Lisa Kellman, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A5062 Issued in CA

Practice address

4560 Admiralty Way Ste 100
Marina del Rey, CA 90292-5424

Phone

(310) 656-1770

NPI assigned

Nov 25, 2006

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

Other identifiers 1

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

Specialty

Emergency Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents University of CaliforniaGroup PAC ID 4082895677, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Merit-based Incentive Payment System (MIPS)

Final score

90.15 of 100Reported as group

Quality

93.43

Promoting interoperability

100

Improvement activities

40

Cost

73.74

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lkellman475055@direct.uclahealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Regents University of California

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1710287297
  Medicare reassignment Care Compare group
• Andy Shen, M.D., Inc.

  • Emergency Medicine Physician
  • Alhambra, CA
  • NPI 1457427221
  Medicare reassignment NPD
• The Regents of the University of California

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1235107566
  Medicare reassignment NPD
• The Regents of the University of California

  • Ambulatory Surgical Clinic/Center
  • Valencia, CA
  • NPI 1689200305
  NPD
• Jse Emergency Medical Group

  • Emergency Medicine Physician
  • Hawaiian Gardens, CA
  • NPI 1851348486
  NPD (past)
• Regents of the University of California

  • Internal Medicine Physician
  • Glendale, CA
  • NPI 1891110888
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248

  Emergency Medicine

  NPD (past)

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

• Regents Univ of Calif Los Angeles

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1902803315
  Care Compare affiliation

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

{
    "created_epoch": "1164412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821164690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY STE 100",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925424",
            "telephone_number": "310-656-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S Raymond Ave",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918013166",
            "country_code": "US",
            "telephone_number": "626-836-3020",
            "fax_number": "626-836-2920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLMAN",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A5062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX50620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Kaplowitz, MD
• Nika Karimi, MD
• Kaster Consultants
• Peter Katona, M.D.
• Yana Katzap-Nackman, BA, IBCLC, RLC
• Anna Elizabeth Kendall, PSY.D.
• Kenneth Landis M D a Medical Corporation
• Bounmany Kyle Keojampa, M.D.
• Kerri Keslow, M.D.
• Ketamine Uplift Inc.

• Emergency Medicine Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.