Individual provider Active NPI

Kelsey Grainger, PA-C

  • Physician Assistant
  • Uniontown, PA
National Provider Identifier
1023531548
Registry record updated Dec 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA061108 Issued in PA
Practice address
500 W Berkeley St
Uniontown, PA 15401-5514
Phone
(724) 430-5600
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2081 WV
Physician Assistant 363A00000X MA061108 PA Primary

Addresses

Primary practice location

500 W Berkeley St
Uniontown, PA 15401-5514

Mailing address

500 W Berkeley St
Uniontown, PA 15401-5514
Phone (724) 430-5600

Other names 1

  • Kelsey Roetenberg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200402002650 PA Practitioner - Physician Assistant 2264704196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fayette Physician Network IncGroup PAC ID 3375865819, 309 clinicians

Practice addresses (Care Compare)

100 Woodlawn Ave
Uniontown, PA 15401-3105
Phone (724) 430-5600

201 Mary Higginson LN
Uniontown, PA 15401-2658
Phone (724) 430-5940

205 Mary Higginson LN
Uniontown, PA 15401-2658
Phone (724) 276-0712

500 W Berkeley St
Uniontown, PA 15401-5514
Phone (724) 430-6899

500 W Berkely St Annex
Uniontown Specialty Care
Uniontown, PA 15401-5514
Phone (724) 430-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA061108PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fayette Physician Network Inc Physician Assistant CurrentSince Feb 22, 2020 Accepting new patients
Fayette Physician Network Inc CurrentSince Feb 22, 2020 Accepting new patients
Fayette Physician Network Inc Past Accepting new patients

Locations

100 Woodlawn Ave
Uniontown, PA 15401
Phone (724) 438-8765

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 3

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607817600000",
    "number": "1023531548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BERKELEY ST",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015514",
            "telephone_number": "724-430-5600",
            "fax_number": "724-430-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BERKELEY ST",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154015514",
            "telephone_number": "724-430-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAINGER",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2020-12-13",
        "certification_date": "2020-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2081",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "ROETENBERG",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Uniontown, PA

Sources for this page

Verify at the official NPI Registry.