NPIMap

Individual provider Active NPI

Kayla Anne Carlson, PA-S

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1841811619
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA206996 Issued in OR
Practice address
61250 SE Coombs PL
Bend, OR 97702-3704
Phone
(541) 706-5930
Fax
(541) 706-5931
NPI assigned
May 2, 2020
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA206996 OR Primary

Addresses

Primary practice location

61250 SE Coombs PL
Bend, OR 97702-3704

Mailing address

2500 NE Neff Rd
Bend, OR 97701-6015
Phone (541) 382-4321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcarlson23030@secure.stcharleshealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20220104001102 OR Practitioner - Physician Assistant 4688065576 Reassigns benefits to 2 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
St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

61250 SE Coombs PL
Family Care Clin
Bend, OR 97702-3704
Phone (541) 706-5935

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA206996ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Charles Health System, Inc. CurrentSince Feb 14, 2022 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 1, 2026 Accepting new patients
St. Charles Health System, Inc. CurrentSince Jan 1, 2026 Accepting new patients
St. Charles Health System, Inc. CurrentSince Feb 14, 2022 Accepting new patients
St. Charles Health System, Inc. Past Accepting new patients

Locations

29358 Network Pl
Chicago, IL 60673

2500 NE Neff Rd
Bend, OR 97701
Phone (541) 388-4333

61250 SE Coombs Pl
Bend, OR 97702
Phone (541) 706-5930

51781 Huntington Rd
La Pine, OR 97739
Phone (541) 666-7920

470 NE A St
Madras, OR 97741
Phone (541) 383-3668

480 NE A St
Madras, OR 97741
Phone (541) 475-4800

211 NW Larch Ave
Redmond, OR 97756
Phone (541) 548-2164

Interoperability endpoints

  • Direct secure messaging: kcarlson23030@secure.stcharleshealthcare.org

Organizations & group practices 5

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 4

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": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1841811619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016015",
            "telephone_number": "541-382-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61250 SE COOMBS PL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023704",
            "telephone_number": "541-706-5930",
            "fax_number": "541-706-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KAYLA",
        "middle_name": "ANNE",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-02",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA206996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarlson23030@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "61250 SE Coombs Pl",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977023704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.