Individual provider Active NPI

Kelsey Marie Harvey, PA-C

  • Physician Assistant
  • Lakewood Ranch, FL
National Provider Identifier
1336799063
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023929 Issued in NY
Practice address
8926 77TH Ter E Unit 101
Lakewood Ranch, FL 34202-6417
Phone
(941) 907-0222
Fax
(941) 907-0493
NPI assigned
Sep 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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 023929 NY Primary

Addresses

Primary practice location

8926 77TH Ter E Unit 101
Lakewood Ranch, FL 34202-6417

Mailing address

102 Avalon Lake Rd
Danbury, CT 06810-7272

Other practice location 1

686 Stoneleigh Ave
Carmel, NY 10512-3931
Phone (845) 279-2957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240903002810 FL Practitioner - Physician Assistant 1254761786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
New York University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emily F Arsenault MD PAGroup PAC ID 9739106584, 24 clinicians

Practice addresses (Care Compare)

5860 Ranch Lake Blvd
Suite 103
Lakewood Ranch, FL 34202-3719
Phone (941) 907-0222

8926 77TH Ter E
Unit 101
Lakewood Ranch, FL 34202-6417
Phone (941) 907-0222

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1336799063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 AVALON LAKE RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8926 77TH TER E UNIT 101",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342026417",
            "telephone_number": "941-907-0222",
            "fax_number": "941-907-0493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "686 Stoneleigh Ave",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105123931",
            "country_code": "US",
            "telephone_number": "845-279-2957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-15",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.