Individual provider Active NPI

Ann B Kelchlin, NP

  • Nurse Practitioner
  • Cobleskill, NY
National Provider Identifier
1013902048
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F331662 Issued in NY
Practice address
132 Macarthur Ave
Cobleskill, NY 12043-3603
Phone
(518) 234-8745
Fax
(518) 234-8756
NPI assigned
Sep 15, 2005
Last updated
Jan 4, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F331662 NY Primary

Addresses

Primary practice location

132 Macarthur Ave
Cobleskill, NY 12043-3603

Mailing address

132 Macarthur Ave
Cobleskill, NY 12043-3603
Phone (518) 234-8745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140820000055 NY Practitioner - Nurse Practitioner 3375761182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians

Practice addresses (Care Compare)

136 Pkwy Dr
Cobleskill, NY 12043-5150
Phone (518) 234-2555

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

Merit-based Incentive Payment System (MIPS)

Final score
92.62 of 100Reported as apm
Quality
77.97
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F331662NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Aug 4, 2014 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Aug 4, 2014 Accepting new patients

Locations

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

Interoperability endpoints

  • Direct secure messaging: akelchlin33304@bassett.direct-ci.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1013902048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 MACARTHUR AVE",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "120433603",
            "telephone_number": "518-234-8745",
            "fax_number": "518-234-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MACARTHUR AVE",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "120433603",
            "telephone_number": "518-234-8745",
            "fax_number": "518-234-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELCHLIN",
        "first_name": "ANN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F331662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cobleskill, NY

Sources for this page

Verify at the official NPI Registry.