Kelly A Peszko

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP015608 Issued in PA

Practice address

2 Bala PLZ
Suite Il-27
Bala Cynwyd, PA 19004-1501

Phone

(610) 668-9999

NPI assigned

Jan 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly A Dipaolo Former name

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trivalley Primary Care PCGroup PAC ID 4981680923, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community at Rockhill, the Nursing home, Sellersville, PA, CCN 395497

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.peszko@tvpc.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/JGDCBA

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.

• Trivalley Primary Care, PC

  • Family Medicine Physician
  • Perkasie, PA
  • NPI 1245295757
  Medicare reassignment Care Compare group NPD
• Delta Medical Group

  • Emergency Medicine Physician
  • Greenville, MS
  • NPI 1790701134
  NPD (past)

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

• The Community at Rockhill

  • Skilled Nursing Facility
  • Sellersville, PA
  • NPI 1437154648

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1453420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1205293131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BALA PLZ",
            "address_2": "SUITE IL-27",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BALA PLZ",
            "address_2": "SUITE IL-27",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041501",
            "telephone_number": "610-668-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESZKO",
        "first_name": "KELLY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-22",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP015608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DIPAOLO",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Personal Touch Home Aides of PA, Inc.
• Personal Touch Home Care of PA, Inc.
• Michelle L Persun, MD
• Caitlin Pertmer, AUD
• Steven S Pesis, DDS
• Natalie Petyk, PSY.D.
• Vivian Pham, RPH
• Phar-More RX, LLC
• Philadelphia Cosmetic Surgery Center
• Philadelphia Counseling Center LLC

• Adult Health Nurse Practitioner in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.