NPIMap

Individual provider Active NPI

Kelly Farrell

  • Physician Assistant
  • Williamsport, PA
National Provider Identifier
1285602722
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051520 Issued in PA
Practice address
740 High St Ste 3002
Suite 3002
Williamsport, PA 17701-3102
Phone
(570) 321-2820
NPI assigned
Mar 10, 2006
Last updated
Jun 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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 MA051520 PA Primary

Addresses

Primary practice location

740 High St Ste 3002
Suite 3002
Williamsport, PA 17701-3102

Mailing address

1201 Grampian Blvd
Suite 3002
Williamsport, PA 17701-1900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address upmchospitals@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040106000202 PA Practitioner - Physician Assistant 3971402231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051520PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Jan 19, 2021 Accepting new patients
Susquehanna Physician Services Physician Assistant CurrentSince Jan 19, 2021 Accepting new patients
Evangelical Community Hospital Past Accepting new patients

Locations

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

1201 Grampian Blvd
Ste 3002
Williamsport, PA 17701

700 High St
Williamsport, PA 17701
Phone (570) 321-2000

700 High St
#P
Williamsport, PA 17701
Phone (570) 321-2619

740 High St
Ste 3002
Williamsport, PA 17701
Phone (570) 321-2820

Interoperability endpoints

  • Direct secure messaging: kelly.farrell@upmcdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1285602722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "address_2": "SUITE 3002",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 HIGH ST STE 3002",
            "address_2": "SUITE 3002",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013102",
            "telephone_number": "570-321-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2021-06-15",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.