KELLI L SCOTT PA
NPI 1104896448
Physician Assistant - Medical in Fountain, CO

Q: What is Kelli Scott's NPI number?

The NPI number for Kelli Scott is 1104896448. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Q: What is Kelli Scott's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: Is Kelli Scott enrolled in Medicare?

No. Kelli Scott has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Kelli Scott was last updated on November 6, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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 January 26, 2006Opted out of Medicare · through Oct 1, 2026

350 LYCKMAN PL, FOUNTAIN, CO 80817(719) 632-5700 Get Directions Write a Review

NPPES record last updated: November 6, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Kelli L Scott Pa NPPES

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

KELLI L SCOTT PA (NPI 1104896448) is an individual medical provider in Fountain, Colorado, licensed in Colorado (3224) and active in the NPI registry since January 2006. She has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1104896448

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameKELLI L SCOTTCredential: PA

Location Address350 LYCKMAN PLFountain, CO 80817-2861

Mailing Address3205 N Academy Blvd, Suite 130Colorado Springs, CO 80917-5147 · (719) 632-5700

Phone(719) 632-5700

Sole ProprietorNo

Enumeration DateJanuary 26, 2006

Last NPPES UpdateNovember 6, 2015

✔ NPI 1104896448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in CO · 3224✔ Licensed in KS · 01042

350 LYCKMAN PL, Fountain, CO 80817

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Other Identifiers 5

Other426914KS · Blue Cross/blue Shield

Medicare UPIN417043YKRDCO

Medicaid89773373CO

Other461466KS · Childrens Mercy Family Hp

Medicare UPINQ53479KS

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Kelli L Scott Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2016 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2016

Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 9

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

PATRICK MICHAEL CASSIDY P.A.-C

Physician Assistant