Individual provider Active NPI

Kelsy Mae Hopkins

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1114791514
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA065200 Issued in PA
Practice address
1703 S Broad St Ste 300
Philadelphia, PA 19148-1536
Phone
(215) 463-5333
Fax
(215) 463-8085
NPI assigned
Nov 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA065200 PA Primary

Addresses

Primary practice location

1703 S Broad St Ste 300
Philadelphia, PA 19148-1536

Mailing address

401 Race St Apt 347
Philadelphia, PA 19106-1029
Phone (267) 421-4118

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240212004299 PA Practitioner - Physician Assistant 9830532332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Practice addresses (Care Compare)

1703 S Broad St
Suite 300
Philadelphia, PA 19148-1536
Phone (215) 463-5333

2301 S Broad St
Philadelphia, PA 19148-3542

525 Jamestown St
Suite 107
Philadelphia, PA 19128-1751
Phone (215) 482-1607

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA065200PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 11, 2025 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Oct 11, 2025 Accepting new patients

Locations

525 Jamestown St
Ste 107
Philadelphia, PA 19128
Phone (215) 482-1607

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

1703 S Broad St
Ste 300
Philadelphia, PA 19148
Phone (215) 462-7100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1114791514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RACE ST APT 347",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061029",
            "telephone_number": "267-421-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S BROAD ST STE 300",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191481536",
            "telephone_number": "215-463-5333",
            "fax_number": "215-463-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKINS",
        "first_name": "KELSY",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA065200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.