KELLY LO CAA
NPI 1093511479
Anesthesiologist Assistant in West Palm Beach, FL

Q: What is Kelly Lo's NPI number?

The NPI number for Kelly Lo is 1093511479. It was assigned to this individual provider in the NPPES registry on February 24, 2025.

Q: What is Kelly Lo's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Lo was last updated on April 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 24, 2025Accepts Medicare Assignment

1309 N FLAGLER DR, WEST PALM BEACH, FL 33401(954) 838-2371 Get Directions Write a Review

NPPES record last updated: April 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 30, 2026, Feb 24, 2025 (2 updates tracked since 2025).

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About Kelly Lo Caa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY LO CAA (NPI 1093511479) is an individual anesthesiologist assistant in West Palm Beach, Florida, licensed in Florida (AA1048) and active in the NPI registry since February 2025. She is affiliated with Good Samaritan Medical Center and is a graduate of Indiana University School Of Medicine (2022).

NPPES Registry Identity

NPI1093511479

Entity TypeIndividualFemale

Primary Taxonomy367H00000X

Provider Legal NameKELLY LOCredential: CAA

Location Address1309 N FLAGLER DRWest Palm Beach, FL 33401-3406

Mailing Address19060 Talon WayJupiter, FL 33458-2446 · (317) 410-6612

Phone(954) 838-2371

Sole ProprietorNo

Medical School CMSIndiana University School Of MedicineGraduated 2022

Enumeration DateFebruary 24, 2025

Last NPPES UpdateApril 30, 20262 updates tracked since enumeration

NPPES CertifiedApril 30, 2026

✔ NPI 1093511479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in FL · AA1048

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

1309 N FLAGLER DR, West Palm Beach, FL 33401

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Lo Caa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800310970

PECOS Enrollment IDI20250410000719

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Good Samaritan Medical Center

Acute Care Hospitals · West Palm Beach, FL

1/5 CMS rating

OwnershipProprietary

CMS Certification Number100287

Location1309 N Flagler DrWest Palm Beach, FL 33401 · Palm Beach County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARLA FAZIO APRN

Nurse Practitioner