Kellie Leeclaire Duarte, M.ED, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60610771 Issued in WA

Practice address

8656 W Gage Blvd Ste 301B
Kennewick, WA 99336-7145

Phone

(509) 222-1275

NPI assigned

Oct 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-City Dermatology PLLCGroup PAC ID 9032529441, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education, Physician Assistant

State licenses

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.

• Tri-City Dermatology PLLC

  • MOHS-Micrographic Surgery Physician
  • Richland, WA
  • NPI 1669070918
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1306034277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8514 W GAGE BLVD",
            "address_2": "SUITE G",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368108",
            "telephone_number": "509-222-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8656 W GAGE BLVD STE 301B",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367145",
            "telephone_number": "509-222-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUARTE",
        "first_name": "KELLIE",
        "middle_name": "LEECLAIRE",
        "credential": "M.ED, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00054737",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "1306034277",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60610771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna M Dreier, PT, DPT
• Leonard A Dreisbach, MD
• Rylie Drury, MSW, LICSWA
• Phillip G Drussel, R.P.T.
• Kari Elizabeth Duane
• Melanie Dumont
• Jeanne Nicole Dunham
• Sheila K Dunlop, D.O.
• Nancy Ruth Dunn, RPH
• Aylin G Duran Torralba, SUDPT

• Physician Assistant in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.