Individual provider Active NPI

Mallory Anne Kairys, CRNP

  • Family Nurse Practitioner
  • Bethel Park, PA
National Provider Identifier
1154831980
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017945 Issued in PA
Practice address
2000 Oxford Dr
Bethel Park, PA 15102-1827
Phone
(412) 942-7900
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017945 PA Primary

Addresses

Primary practice location

2000 Oxford Dr
Bethel Park, PA 15102-1827

Mailing address

2000 Oxford Dr
Bethel Park, PA 15102-1827
Phone (412) 942-7900

Other names 1

  • Mallory Anne Dugas Former name

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
I20181227000150 PA Practitioner - Nurse Practitioner 0648515361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Clair Medical Services IncGroup PAC ID 4183511553, 203 clinicians

Practice addresses (Care Compare)

1000 Bower Hill Rd
Pittsburgh, PA 15243-1873

Hospital & facility affiliations

  • St Clair Hospital Hospital, Pittsburgh, PA, CCN 390228

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair Medical Services, Inc. Current Accepting new patients
St Clair Medical Services Inc CurrentSince May 9, 2022 Accepting new patients
Washington Physician Services CurrentSince Nov 1, 2018 Accepting new patients
St. Clair Medical Services, Inc. CurrentSince May 9, 2022 Accepting new patients
St Clair Medical Services Inc Past Accepting new patients

Locations

2000 Oxford Dr
Ste 305
Bethel Park, PA 15102
Phone (412) 942-7900

2000 Oxford Dr
Bethel Park, PA 15102
Phone (412) 344-6600

5000 Waterdam Plaza Dr
Ste 120
McMurray, PA 15317
Phone (412) 942-7900

1000 Bower Hill Rd
Ste 7400
Pittsburgh, PA 15243
Phone (412) 429-8840

1000 Bower Hill Rd
Pittsburgh, PA 15243
Phone (412) 344-6600

190 N Main St
Ste 204
Washington, PA 15301
Phone (724) 223-9335

125 N Franklin Dr
Ste 1
Washington, PA 15301
Phone (724) 225-6500

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1154831980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021827",
            "telephone_number": "412-942-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OXFORD DR",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151021827",
            "telephone_number": "412-942-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIRYS",
        "first_name": "MALLORY",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "DUGAS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethel Park, PA

Sources for this page

Verify at the official NPI Registry.