NPIMap

Individual provider Active NPI

Kelly Sabaluski, CRNP

  • Nurse Practitioner
  • Millville, PA
National Provider Identifier
1083198964
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP019126 Issued in PA
Practice address
515 Jerseytown Rd
Millville, PA 17846-8825
Phone
(570) 458-5597
Fax
(570) 458-5114
NPI assigned
Sep 18, 2018
Last updated
Dec 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP019126 PA Primary
Family Nurse Practitioner 363LF0000X SP019126 PA

Addresses

Primary practice location

515 Jerseytown Rd
Millville, PA 17846-8825

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
SP019126OtherPAPA CRNP LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelly.sabaluski.1@21771.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181120000213 PA Practitioner - Nurse Practitioner 6608120167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

515 Jerseytown Rd
Millville, PA 17846-8825
Phone (570) 458-5597

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP019126PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Nurse Practitioner CurrentSince Dec 20, 2021 Accepting new patients
Geisinger Clinic CurrentSince Dec 20, 2021 Accepting new patients
Geisinger-HM Joint Venture, LLC Nurse Practitioner Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

2407 Reichart Rd
Bloomsburg, PA 17815
Phone (570) 784-6320

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

701 W Oak St
Frackville, PA 17931
Phone (570) 874-4100

515 Jerseytown Rd
Millville, PA 17846
Phone (570) 458-5597

Interoperability endpoints

  • Direct secure messaging: kelly.sabaluski.1@21771.direct.athenahealth.com
  • Direct secure messaging: ksabaluski235382@direct.geisinger.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1083198964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 JERSEYTOWN RD",
            "city": "MILLVILLE",
            "state": "PA",
            "postal_code": "178468825",
            "telephone_number": "570-458-5597",
            "fax_number": "570-458-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABALUSKI",
        "first_name": "KELLY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP019126",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP019126",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA CRNP LICENSE",
            "identifier": "SP019126",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.sabaluski.1@21771.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "176 N Main St",
            "city": "Shavertown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187081121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Millville, PA

Sources for this page

Verify at the official NPI Registry.