Kelly A Stensrud, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-005776 Issued in VA

Practice address

637 Kingsborough SQ Ste E
Chesapeake, VA 23320-4944

Phone

(757) 410-2804

Fax

(757) 410-2824

NPI assigned

Jun 15, 2017

Last updated

Jul 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly A Boyle Former name

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Virginia Neurology and Sleep Center PC

  • Neurology Physician
  • Chesapeake, VA
  • NPI 1790810455
  Medicare reassignment
• Orthopaedic Surgery Centers, PC II

  • Durable Medical Equipment & Medical Supplies
  • Portsmouth, VA
  • NPI 1831273192
  NPD (past)

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1053841726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 FULLER LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234554211",
            "telephone_number": "651-757-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 KINGSBOROUGH SQ STE E",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204944",
            "telephone_number": "757-410-2804",
            "fax_number": "757-410-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENSRUD",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-005776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BOYLE",
            "middle_name": "A",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Catherine Staten, PT, DPT
• Janice Staton
• Tammy Steckler-Cucca, M.ED., M.S., BCBA
• Craig A Steele
• Lori L Steele, MS, CCC-SLP
• Step Ahead ABA VA LLC
• Amy R. Stephan, LCSW
• Stephanie M. Hadley
• Stephen a. Asam, D.D.S., P.C. (a division of Atlantic Dental Care)
• Andrea Rosalind Stephen, LPC

• Physician Assistant in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.