Kaylie Alexandra Temporal, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA09471 Issued in TX

Practice address

824 Southpark Cir
Athens, TX 75752-6943

Phone

(903) 675-7376

Fax

(903) 677-4234

NPI assigned

Oct 13, 2014

Last updated

Apr 27, 2015By 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

Other names 1

• Kaylie Alexandra Eldore Former name

Medicare fee-for-service enrollment

Enrolled in TX

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mark L Eldore MD PLLCGroup PAC ID 9335457050, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kaylie.temporal.1@15619.direct.athenahealth.com

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.

• Mark L Eldore MD PLLC

  dba Athens Women's and Children's Center

  • Obstetrics & Gynecology Physician
  • Athens, TX
  • NPI 1831107028
  Medicare reassignment Care Compare group

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1861896300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 SOUTHPARK CIR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757526943",
            "telephone_number": "903-675-7376",
            "fax_number": "903-677-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 SOUTHPARK CIR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757526943",
            "telephone_number": "903-675-7376",
            "fax_number": "903-677-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPORAL",
        "first_name": "KAYLIE",
        "middle_name": "ALEXANDRA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLIE",
            "last_name": "ELDORE",
            "middle_name": "ALEXANDRA",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Leigh Swinnea, LMSW
• Shawn Tai, M.D.
• Jay Takata
• Melissa Tatum, LPC
• Ralph Wayne Templin, D.O.
• Teri Lynne Baumgartner M.D. PLLC (Athen's Women's Health Center)
• Teri Lynne Baumgartner PLLC (Athens Women's Health Center)
• Teresa Jan Thompson, LPC 13076
• Frederick Allen Thurmond, MD
• Tina P. Elkins MD PA

• Physician Assistant in Athens, TX
• Providers in Athens, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.