Individual provider Active NPI

Kelly A Toth, PAC

  • Physician Assistant
  • Lehighton, PA
National Provider Identifier
1043276470
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA052339 Issued in PA
Practice address
211 N 11TH Street
Lehighton, PA 18235
Phone
(610) 377-7080
NPI assigned
Apr 25, 2006
Last updated
Apr 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA052339 PA Primary

Addresses

Primary practice location

211 N 11TH Street
Lehighton, PA 18235

Mailing address

PO Box 1754
Allentown, PA 18105-1754
Phone (484) 884-0183

Other names 1

  • Kelly A Pietrouchie 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
I20060426000709 PA Practitioner - Physician Assistant 2466462213 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. CurrentSince Oct 10, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2017 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jun 1, 2017 Accepting new patients
Lehigh Gorge Inpatient Services, PLLC Past Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Regents of the University of California - Ucsd Medical Group Past Accepting new patients
Broad Mountain Emergency Physicians, PLLC Past Accepting new patients

Locations

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

Interoperability endpoints

  • Direct secure messaging: ktoth12036@direct2.lvhn.org

Organizations & group practices 9

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1043276470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1754",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181051754",
            "telephone_number": "484-884-0183",
            "fax_number": "484-884-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N 11TH STREET",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "18235",
            "telephone_number": "610-377-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOTH",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "PIETROUCHIE",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lehighton, PA

Sources for this page

Verify at the official NPI Registry.