Individual provider Active NPI

Kelly Elizabeth Beltran, P.A.

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1891864849
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60017286 Issued in WA
Practice address
1321 Colby Ave
Emergency Department
Everett, WA 98201-1665
Phone
(425) 261-2000
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18715 CA
Physician Assistant 363A00000X 60017286 WA Primary

Addresses

Primary practice location

1321 Colby Ave
Emergency Department
Everett, WA 98201-1665

Mailing address

1001 N Broadway
#A11
Everett, WA 98201-1586
Phone (425) 259-0212

Other identifiers 1

IdentifierTypeStateIssuer
PA18715MedicaidCA

Other names 1

  • Kelly Elizabeth Lee Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20170821001333 AZ Practitioner - Physician Assistant 0244239929 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18715CAMDPhysician Assistant
60017286WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Emergency Associates, LTD. Physician Assistant CurrentSince Jun 1, 2019 Accepting new patients
Honorhealth CurrentSince Jul 25, 2023 Accepting new patients
Honorhealth CurrentSince Jul 25, 2023 Accepting new patients

Locations

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

5316 E Shea Blvd
Ste 150
Scottsdale, AZ 85254
Phone (480) 534-4530

13737 Noel Rd
Ste 1600
Dallas, TX 75240
Phone (214) 712-2489

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1891864849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N BROADWAY",
            "address_2": "#A11",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011586",
            "telephone_number": "425-259-0212",
            "fax_number": "425-259-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-261-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18715",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60017286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA18715",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "LEE",
            "middle_name": "ELIZABETH",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.