DR. KELLEY CORENNE GILLETTE M.D.
NPI 1619364577
Pediatrics in Los Angeles, CA
About Dr. Kelley Corenne Gillette M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KELLEY CORENNE GILLETTE M.D. (NPI 1619364577) is an individual pediatrics provider in Los Angeles, California, licensed in California (143943) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Loma Linda, and is a graduate of Creighton University School Of Medicine (2015).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Kelley Corenne Gillette M.d. 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.
Medicare Billing Reassignment
Medicare enrollment records show Kelley Gillette reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Childrens Hospital Los Angeles Medical Group Inc
- 1,281 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90027 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
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 Kelley Gillette's NPI number?
The NPI number for Kelley Gillette is 1619364577. It was assigned to this individual provider in the NPPES registry on April 17, 2015.
Where is Kelley Gillette located?
Kelley Gillette practices at 4650 W Sunset Blvd, Los Angeles, CA 90027. The listed phone number is (954) 558-7097.
What is Kelley Gillette's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Kelley Gillette enrolled in Medicare?
Yes. Kelley Gillette is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kelley Gillette's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Gillette reassigns Medicare benefits to Children's Hospital Los Angeles Medical Group, Inc. (Los Angeles, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelley Gillette's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelley Gillette was last updated on March 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Dr. Kelley Corenne Gillette, M.D. · NPI 1619364577
Pediatrics physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since April 17, 2015.
## Identity
- **NPI:** 1619364577 (Entity type: Individual)
- **Enumerated:** April 17, 2015
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 143943 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4650 W SUNSET BLVD, Los Angeles, CA 90027
- **Phone:** (954) 558-7097
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Children's Hospital Los Angeles Medical Group, Inc. (NPI 1265530653, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Creighton University School Of Medicine, class of 2015
## Record status
- **NPPES last updated:** March 18, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1619364577) · Data from the CMS NPPES public registry.