Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly SIU

Individual provider Physician Assistant · NPI 1104541499

Kelly SIU is a Physician Assistant in Las Vegas, Nevada. Graduated from Touro Un Col of Osteopathic Medicine, Henderson in 2022, 4 years ago. Practices with Optum Medical Group II Rhodes P C, a 302-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
Trained at
Touro Un Col of Osteopathic Medicine, Henderson
In the registry since
2022
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Practice location Address checks out

4750 W Oakey Blvd
Las Vegas, NV 89102-1535
Phone: (702) 877-5199
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104541499
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 10, 2022
Last updated in NPPESFebruary 20, 2024
Certification dateFebruary 20, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolTOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Graduated 2022 (4 years in practice)
Group practice Optum Medical Group Ii Rhodes P C — 302 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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