Kelly M. Pitzer, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

3050 Mack Rd
Suite 200
Fairfield, OH 45014-5379

Phone

(513) 924-8915

Fax

(513) 924-8929

NPI assigned

Jul 30, 2013

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 identifiers 1

Other names 1

• Kelly M. Brueggen Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthocincy Orthopaedics and Sports Medicine PSCGroup PAC ID 3173500196, 163 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health - Clermont Hospital Hospital, Batavia, OH, CCN 360236
• Mercy Health-Anderson Hospital Hospital, Cincinnati, OH, CCN 360001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Orthocincy Orthopaedics & Sports Medicine PSC

  • Orthopaedic Surgery Physician
  • Edgewood, KY
  • NPI 1598714560

  OH

  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Cincinnati Specialty Care LLC

  • Surgery Physician
  • Blue Ash, OH
  • NPI 1154942795
  Medicare reassignment NPD
• Mercy Health Physicians Cincinnati LLC

  dba Mercy Health - Orthopaedics and Spine, Liberty Falls

  • Durable Medical Equipment & Medical Supplies
  • Liberty Township, OH
  • NPI 1790281517
  NPD
• Mercy Health Physicians Cincinnati Specialty Care LLC

  dba Mercy Health- Kyles Station Orthopedic and Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Liberty TWP, OH
  • NPI 1730993270
  NPD
• Mercy Health Physicians Cincinnati, LLC

  • Family Medicine Physician
  • Blue Ash, OH
  • NPI 1205887023
  NPD
• Orthocincy Orthopaedics & Sports Medicine PSC

  • Physical Therapist
  • Montgomery, OH
  • NPI 1003791054
  NPD

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

• Mercy Health - Anderson Hospital LLC

  dba Mercy Hospital Anderson

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1235239211
  Care Compare affiliation
• Mercy Health - Clermont Hospital LLC

  dba Clermont Hospital

  • General Acute Care Hospital
  • Batavia, OH
  • NPI 1568562551
  Care Compare affiliation

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1073945267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 MACK RD",
            "address_2": "SUITE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145379",
            "telephone_number": "513-924-8915",
            "fax_number": "513-924-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MACK RD",
            "address_2": "SUITE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145379",
            "telephone_number": "513-924-8915",
            "fax_number": "513-924-8929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6620 Clough Pike",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452444053",
            "country_code": "US",
            "telephone_number": "513-232-2663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITZER",
        "first_name": "KELLY",
        "middle_name": "M.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091479",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BRUEGGEN",
            "middle_name": "M.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Barbara J Piper
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• Nicholas Brand Pleat, DO
• Podiatry Associates of Ohio (Centers for Foot & Ankle Care LLC)
• Luz C Polanco

• Surgical Physician Assistant in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Surgical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.