Active NPI
Kelsi Marie Rau, RN, NP
- Nurse Practitioner
- Simi Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95028896
- Practice address
- 1424 Madera Rd
Simi Valley, CA 93065-3053 - Phone
- (805) 522-5722
- NPI assigned
- Jun 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2346727 | MA | |
| Nurse Practitioner | 363L00000X | 95028896 | CA | Primary |
| Nurse Practitioner | 363L00000X | 2346727 | MA |
Addresses
Primary practice location
1424 Madera Rd
Simi Valley, CA 93065-3053
Mailing address
137 Peterborough St Apt 14
Boston, MA 02215-4212
Phone (904) 238-5215
Other practice location 1
137 Peterborough St Apt 14
Boston, MA 02215-4212
Phone (904) 238-5215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2346727 | MA | MD | Registered Nurse |
| 95028896 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lynn Community Health, Inc. | Current | Accepting new patients | |
| Clinicas del Camino Real Inc | Current | Accepting new patients | |
| Clinicas del Camino Real Inc | Current | Accepting new patients | |
| Clinicas del Camino Real Inc | Current | Accepting new patients |
Locations
730 Paseo Camarillo
Camarillo, CA 93010
Phone (805) 920-7021
500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895
1424 Madera Rd
Simi Valley, CA 93065
Phone (805) 522-5722
269 Union St
Lynn, MA 01901
Phone (781) 581-9832
280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555
Interoperability endpoints
- krau320149@direct.ochin.org
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Ventura, CA
- NPI 1679631907
-
- Federally Qualified Health Center (FQHC)
- Lynn, MA
- NPI 1013997691
-
- Federally Qualified Health Center (FQHC)
- Santa Paula, CA
- NPI 1023234465
-
- Community Health Clinic/Center
- Oxnard, CA
- NPI 1235866138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710201600000",
"number": "1972173359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 PETERBOROUGH ST APT 14",
"city": "BOSTON",
"state": "MA",
"postal_code": "022154212",
"telephone_number": "904-238-5215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1424 MADERA RD",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930653053",
"telephone_number": "805-522-5722"
}
],
"practiceLocations": [
{
"address_1": "137 Peterborough St Apt 14",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "022154212",
"country_code": "US",
"telephone_number": "904-238-5215",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAU",
"first_name": "KELSI",
"middle_name": "MARIE",
"credential": "RN, NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-29",
"last_updated": "2024-03-12",
"certification_date": "2024-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MA",
"license": "2346727",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95028896",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "2346727",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.