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MRS. KYLIE ELIZABETH CAMPBELL PA-C
NPI 1558514281
Physician Assistant - Medical in El Dorado Hills, CA

Active since October 26, 2008Opted out of Medicare · through Jul 1, 2028
4921 GOLDEN FOOTHILL PKWY, EL DORADO HILLS, CA 95762(916) 983-5771(916) 939-1800 Get Directions Write a Review

NPPES record last updated: May 21, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 21, 2020, Mar 23, 2018 (2 updates tracked since 2018).

About Mrs. Kylie Elizabeth Campbell Pa-c NPPES

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

MRS. KYLIE ELIZABETH CAMPBELL PA-C (NPI 1558514281) is an individual medical provider in El Dorado Hills, California, licensed in California (19985) and active in the NPI registry since October 2008. She has opted out of Medicare through July 1, 2028 and remains eligible to order and refer and maintains a secondary practice location in Costa Mesa.

NPPES Registry Identity

NPI1558514281
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. KYLIE ELIZABETH CAMPBELLCredential: PA-C
Location Address4921 GOLDEN FOOTHILL PKWYEl Dorado Hills, CA 95762-9632
Mailing AddressPo Box 5156El Dorado Hills, CA 95762-0003 · (530) 400-9674 · Fax (916) 939-1800
Phone(916) 983-5771
Fax(916) 939-1800
Sole ProprietorYes
Enumeration DateOctober 26, 2008
Last NPPES UpdateMay 21, 20202 updates tracked since enumeration
NPPES CertifiedMay 21, 2020
✔ NPI 1558514281 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
License✔ Licensed in CA · 19985
4921 GOLDEN FOOTHILL PKWY, El Dorado Hills, CA 95762
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Other Names 1

Former Name (1)Ms. Kylie Elizabeth Nuckols Pa-c

Secondary Practice Location 1

Location 11831 Orange Avenue, Suite CCosta Mesa, CA 92627 · Phone (949) 574-5800 · Fax (949) 612-2725

Other Identifiers 1

Other952979638CA · Federal Id Number

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Kylie Elizabeth Campbell Pa-c 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 July 1, 2020 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2020
Opt-Out In Effect ThroughJuly 1, 2028Opt-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 3

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

FOLSOM CARDIOLOGY INC
Internal Medicine (Cardiovascular Disease)
4921 GOLDEN FOOTHILL PKWY
EL DORADO HILLS, CA 95762
El Dorado County (916) 597-2687
AJAY KUMAR JOSHI M.D., MRCP, FACC
Internal Medicine (Interventional Cardiology)
4921 GOLDEN FOOTHILL PKWY
EL DORADO HILLS, CA 95762
El Dorado County (916) 597-2687
LAUREN LEE
Physician Assistant
4921 GOLDEN FOOTHILL PKWY
EL DORADO HILLS, CA 95762
El Dorado County (916) 597-2687

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kylie Campbell's NPI number?

The NPI number for Kylie Campbell is 1558514281. It was assigned to this individual provider in the NPPES registry on October 26, 2008. The provider is also known as Ms. Kylie Elizabeth Nuckols Pa-C.

Where is Kylie Campbell located?

Kylie Campbell practices at 4921 Golden Foothill Pkwy, El Dorado Hills, CA 95762. The listed phone number is (916) 983-5771.

What is Kylie Campbell's specialty?

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

Is Kylie Campbell enrolled in Medicare?

No. Kylie Campbell has opted out of Medicare through July 1, 2028. 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.

When was this NPI record last updated?

The NPPES record for Kylie Campbell was last updated on May 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.