Individual provider Active NPI

Mary Kathleen Kirchner

  • Physician Assistant
  • Kingston, PA
National Provider Identifier
1215726179
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
610 Wyoming Ave
Kingston, PA 18704-3702
Phone
(570) 288-5441
NPI assigned
May 6, 2025
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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 Primary

Addresses

Primary practice location

610 Wyoming Ave
Kingston, PA 18704-3702

Mailing address

1206 Moltke Ave
Scranton, PA 18505-3950

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
I20250801003670 PA Practitioner - Physician Assistant 8123536059 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
Telehealth
Offers telehealth services
Group practices
Commonwealth Physician Network LLCGroup PAC ID 2668696592, 63 clinicians

Practice addresses (Care Compare)

1099 S Township Blvd
Pittston, PA 18640-3247
Phone (570) 602-2400

176 N Main St
Shavertown, PA 18708-1121
Phone (570) 675-0900

4 E Main St
Nanticoke, PA 18634-1602
Phone (570) 735-7474

610 Wyoming Ave
Kingston, PA 18704-3702
Phone (570) 288-5441

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mary.kirchner.1@21771.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1215726179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 MOLTKE AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185053950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043702",
            "telephone_number": "570-288-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHNER",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

Verify at the official NPI Registry.