Individual provider Active NPI

Kelley Anne Humbert, M.D.

  • Vascular Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1184038648
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
MD464236 Issued in PA
Practice address
3400 Spruce St
Philadelphia, PA 19104-4238
Phone
(215) 662-4000
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD464236 PA
Vascular Neurology Physician 2084V0102X MD464236 PA Primary

Addresses

Primary practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-4000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201102001711 PA Practitioner - Neurology 8729317847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Harvard Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Philadelphia, PA 19104-5127
Phone (215) 662-3606

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD464236PAMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Oct 1, 2020 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 1, 2020 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

Locations

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

Interoperability endpoints

  • Direct secure messaging: kelley.humbert.1@18824.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1184038648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBERT",
        "first_name": "KELLEY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD464236",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "PA",
            "license": "MD464236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.