Andrew John Kelly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA002419L Issued in PA

Practice address

824 Main Street, Suite 100
Phoenixville, PA 19460

Phone

(610) 935-7300

NPI assigned

Aug 31, 2006

Last updated

Oct 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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.

• Clinical Care Associates of the University of Pennsylvania Health

  • Internal Medicine Physician
  • Radnor, PA
  • NPI 1972682995
  Medicare reassignment
• Penn Medicine-Pma

  • Internal Medicine Physician
  • Audubon, PA
  • NPI 1144895970
  Medicare reassignment
• Penn Medicine-Pma

  • Pulmonary Disease Physician
  • Phoenixville, PA
  • NPI 1457023277
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1073625018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 MAIN STREET, SUITE 100",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "19460",
            "telephone_number": "610-935-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 MAIN STREET, SUITE 100",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "19460",
            "telephone_number": "610-935-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA002419L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory F Keenan, M.D.
• Oladoye O Kehinde, MD
• Stacey Keller, CPS
• Bridgette Kelliher
• Cynthia Kellogg, M.D.
• Kimberly Kelly, M.A., L.P.C
• Colleen Kennedy
• Taylor Kenny
• Jane Kepics
• Mary Kereda, MA. BSL

• Physician Assistant in Phoenixville, PA
• Providers in Phoenixville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.