KELLY KATHLEEN BALLETTI – Medical Physician Assistant, NPI 1790218634

KELLY KATHLEEN BALLETTI is a healthcare provider. based in Coral gables, Florida. specializing in PHYSICIAN ASSISTANT. They hold a License No. 9110317 (FL). The NPI Number for KELLY KATHLEEN BALLETTI is 1790218634

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
KELLY KATHLEEN BALLETTI
NPI
1790218634
Phone
(305) 444-4979
Address
135 SAN LORENZO AVE
Enumeration Date
7 April 2017
Last Update Date
28 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3054444979
Graduation Year
2017 (9 years ago)
PAC ID
6507133006
Group Practice PAC ID
0749717346
Professional Enrollment ID
I20170605002895
Address ID
FL331461876CO135XXAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

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Provider Addresses for KELLY KATHLEEN BALLETTI

  • Berkshire Hathaway Home Services Florida Realty, 135, San Lorenzo Avenue, Coral Gables, Miami-Dade County, Florida, 33146, United States

    SUITE #700

    CORAL GABLES, FL 331461524

    Phone: (305) 444-4979

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $64.

Total Amount is formed as General ($64) + Research ($0) + Ownership ($0) = $64.

Last reported payment date: 2024-06-20 • Largest payer in this snapshot: Boston Scientific Corporation ($33).

Total Amount

$64

General + Research + Ownership

Payments

2

Total payment records

General Amount

$64

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-06-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170605002895IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33146)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749717346View full group profile
NameSpecialtyState
Micrographic Dermatologic Surgery (Mds), DermatologyFL

Reviews

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Frequently asked questions

What federal number belongs to KELLY KATHLEEN BALLETTI?
The federal identifier for KELLY KATHLEEN BALLETTI is NPI 1790218634.
Is KELLY KATHLEEN BALLETTI's NPI currently valid?
The extract we use shows KELLY KATHLEEN BALLETTI as active.
What field does KELLY KATHLEEN BALLETTI work in?
You can think of KELLY KATHLEEN BALLETTI as practicing within Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Does KELLY KATHLEEN BALLETTI practice in Florida?
You will see Coral Gables, Florida on file for KELLY KATHLEEN BALLETTI alongside any extra practice locations.
How can I contact KELLY KATHLEEN BALLETTI?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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