Individual provider Active NPI

Kayla Ann Macmullin, PA-C

  • Physician Assistant
  • Hershey, PA
National Provider Identifier
1215709308
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA064827 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(717) 531-8407
Fax
(717) 531-3741
NPI assigned
Oct 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA064827 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

500 University Dr MC Ca410
Hershey, PA 17033-2360
Phone (717) 531-1159

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
I20240102000049 PA Practitioner - Physician Assistant 3072963271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians

Practice addresses (Care Compare)

500 Universidy Dr
Hershey, PA 17033-2360

Hospital & facility affiliations

  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Jan 2, 2024 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jan 2, 2024 Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

3025 Market St
Camp Hill, PA 17011
Phone (717) 691-1212

121 N Nyes Rd
Ste E
Harrisburg, PA 17112
Phone (717) 703-3649

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

2221 Noll Dr
Fl 1
Lancaster, PA 17603
Phone (717) 715-1001

941 Park Dr
Palmyra, PA 17078
Phone (717) 531-8814

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.

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": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1215709308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR MC CA410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-1159",
            "fax_number": "717-531-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8407",
            "fax_number": "717-531-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACMULLIN",
        "first_name": "KAYLA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.