NPIMap

Individual provider Active NPI

Kyle Michael Sutherland, PA-C

  • Physician Assistant
  • Clearfield, PA
National Provider Identifier
1295331791
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1171989 Issued in PA
Practice address
531 Hannah St
Clearfield, PA 16830-1245
Phone
(814) 765-2261
NPI assigned
Dec 9, 2020
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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 1171989 PA Primary

Addresses

Primary practice location

531 Hannah St
Clearfield, PA 16830-1245

Mailing address

235 Harris Ave
Boalsburg, PA 16827-1239
Phone (814) 409-8652

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
I20210520001826 PA Practitioner - Physician Assistant 6901205145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J C Blair Memorial HospitalGroup PAC ID 2668378407, 98 clinicians

Practice addresses (Care Compare)

1227 Warm Springs
201 PHHD Palliative Care
Huntingdon, PA 16652-2300
Phone (814) 643-8255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1171989PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Physician Assistant CurrentSince Apr 21, 2021 Accepting new patients
Dubois Regional Medical Center CurrentSince Apr 21, 2021 Accepting new patients
J C Blair Memorial Hospital Physician Assistant CurrentSince Jun 17, 2024 Accepting new patients
J C Blair Memorial Hospital CurrentSince Jun 17, 2024 Accepting new patients
JC Blair Memorial Hospital Physician Assistant Past Accepting new patients

Locations

531 Hannah St
Clearfield, PA 16830
Phone (814) 765-1982

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

1225 Warm Springs Ave
Huntingdon, PA 16652
Phone (814) 643-8206

1227 Warm Springs Ave
Ste 201
Huntingdon, PA 16652
Phone (814) 643-8668

Interoperability endpoints

  • Direct secure messaging: kmsutherland@1285.direct.myezyaccess.com

Organizations & group practices 6

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 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1295331791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 HARRIS AVE",
            "city": "BOALSBURG",
            "state": "PA",
            "postal_code": "168271239",
            "telephone_number": "814-409-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 HANNAH ST",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168301245",
            "telephone_number": "814-765-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "KYLE",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "1171989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, PA

Sources for this page

Verify at the official NPI Registry.