NPIMap

Individual provider Active NPI

Kellie Condon, PA-C

  • Physician Assistant
  • Peabody, MA
National Provider Identifier
1093468894
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8597 Issued in MA
Practice address
2 Essex Center Dr Ste 1
Peabody, MA 01960-2930
Phone
(978) 977-4000
NPI assigned
Feb 1, 2022
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA8597 MA Primary

Addresses

Primary practice location

2 Essex Center Dr Ste 1
Peabody, MA 01960-2930

Mailing address

Provider Enrollment 41 Mall Road
Burlington, MA 01805-0001

Other practice location 1

440 Foley St
Somerville, MA 02145-1213
Phone (857) 282-0777

Other practice location 2

305 Gloucester Crossing Rd
Gloucester, MA 01930-2283
Phone (978) 381-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220419001544 MA Practitioner - Physician Assistant 7719374990 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

1350 Market St
Lynnfield, MA 01940-4048
Phone (781) 213-4050

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Physician Assistant CurrentSince May 16, 2022 Accepting new patients
Atrius Health, Inc. CurrentSince May 16, 2022 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Jul 25, 2024 Accepting new patients
General Hospital Corp Current Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Jan 3, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Jan 3, 2024 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 29, 2024 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Jul 25, 2024 Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Physician Assistant Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8085

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

305 Gloucester Crossing Rd
Gloucester, MA 01930
Phone (978) 304-8380

2 Essex Center Dr
Ste 1
Peabody, MA 01960
Phone (978) 977-4000

440 Foley St
Somerville, MA 02145
Phone (857) 282-0777

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • Direct secure messaging: condon.kellie.mgh@direct.partners.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kcondon161506@direct.bilh.masshiway.net
  • Direct secure messaging: kcondonpac345882@direct.atrius.masshiway.net

Organizations & group practices 12

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1093468894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PROVIDER ENROLLMENT 41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ESSEX CENTER DR STE 1",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602930",
            "telephone_number": "978-977-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Foley St",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "MA",
            "postal_code": "021451213",
            "country_code": "US",
            "telephone_number": "857-282-0777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Gloucester Crossing Rd",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "MA",
            "postal_code": "019302283",
            "country_code": "US",
            "telephone_number": "978-381-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONDON",
        "first_name": "KELLIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-01",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.