Carly Elizabeth Haddock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062781 Issued in PA

Practice address

701 Ostrum St Ste 201
Fountain Hill, PA 18015-1152

Phone

(484) 526-6545

Fax

(484) 526-6546

NPI assigned

Jul 31, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carly Elizabeth Mischello 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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049
• St Luke'S Miners Memorial Hospital Hospital, Coaldale, PA, CCN 390183
• St Luke'S Hospital - Carbon Campus Hospital, Lehighton, PA, CCN 390335
• St Luke'S Hospital - Monroe Campus Hospital, Stroudsburg, PA, CCN 390330
• St Luke'S Hospital - Upper Bucks Campus Hospital, Quakertown, PA, CCN 390035

Merit-based Incentive Payment System (MIPS)

Final score

97.13 of 100Reported as apm

Quality

82.27

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carly.haddock@slpg.direct-sluhn.org

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.

• St. Luke'S Physician Group, Inc.

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment Care Compare group
• St Luke'S Physician Group Inc

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD
• St. Luke'S Physician Group, Inc.

  • Pediatric Critical Care Medicine Physician
  • Bethlehem, PA
  • NPI 1811535982
  NPD
• St. Luke'S Physician Group, Inc

  • Obstetrics & Gynecology Physician
  • Bethlehem, PA
  • NPI 1447801535
  NPD (past)

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

• St Luke'S Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1366011413
  Care Compare affiliation
• St Luke'S Hospital

  • General Acute Care Hospital
  • Easton, PA
  • NPI 1376339226
  Care Compare affiliation
• St Luke'S Hospital

  • General Acute Care Hospital
  • Lehighton, PA
  • NPI 1528737988
  Care Compare affiliation
• St Lukes Hospital

  • General Acute Care Hospital
  • Bethlehem, PA
  • NPI 1013933175
  Care Compare affiliation
• St Lukes Quakertown Hospital

  • General Acute Care Hospital
  • Quakertown, PA
  • NPI 1669405072
  Care Compare affiliation
• St. Luke'S Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1548293954
  Care Compare affiliation
• St. Luke'S Hospital Bethlehem

  • Adult Mental Health Clinic/Center
  • Lehighton, PA
  • NPI 1962094920

  Hospital

  Care Compare affiliation
• St. Luke'S Hospital Monroe Campus

  • General Acute Care Hospital
  • Stroudsburg, PA
  • NPI 1396194197
  Care Compare affiliation
• St. Luke'S Hospital-Carbon Campus

  • General Acute Care Hospital
  • Lehighton, PA
  • NPI 1699340927
  Care Compare affiliation
• The Carbon-Schuylkill Community Hospital, Inc.

  • General Acute Care Hospital
  • Coaldale, PA
  • NPI 1437182847
  Care Compare affiliation

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1295389849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 201",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151152",
            "telephone_number": "484-526-6545",
            "fax_number": "484-526-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OSTRUM ST STE 201",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151152",
            "telephone_number": "484-526-6545",
            "fax_number": "484-526-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "CARLY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0110-006780",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "MISCHELLO",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaylee Grapsy
• Ashley Brooke Graul, MD
• Alicia Grim
• Giuseppe Guglielmello, DO
• Jenna Gutsin, OTR/L
• Kelly L. Hamati, CRNP
• Sumayah Hargette, MD
• Meredith Anne Harrison, MD
• Tina Hartman
• Craig T Haytmanek, M.D.

• Physician Assistant in Fountain Hill, PA
• Providers in Fountain Hill, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.