Kelly Meyer, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

013334 Issued in NY

Practice address

4 Feathers Drive
Champlain Spine & Pain Management
Plattsbugh, NY 12901-0641

Phone

(183) 247-2465

Fax

(518) 324-3366

NPI assigned

May 5, 2009

Last updated

Oct 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Adirondack Interventional Physiatry PCGroup PAC ID 1254308463, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250
• The University of Vermont Health Network-Alice Hy Hospital, Malone, NY, CCN 331321
• Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079
• Elizabethtown Community Hospital Hospital, Elizabethtown, NY, CCN 331302

Merit-based Incentive Payment System (MIPS)

Final score

87.45 of 100Reported as group

Quality

90

Improvement activities

40

Cost

62.13

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Adirondack Interventional Physiatry PC

  dba Champlain Spine & Pain Mgt

  • Interventional Pain Medicine Physician
  • Plattsburgh, NY
  • NPI 1821166166
  Medicare reassignment Care Compare group
• Surgical Pain Center of the Adirondacks, LLC

  • Ambulatory Surgical Clinic/Center
  • Plattsburgh, NY
  • NPI 1528553559
  NPD (past)

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

• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1699709576
  Care Compare affiliation
• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1851601108
  Care Compare affiliation
• Alice Hyde Medical Center

  • Critical Access Hospital
  • Malone, NY
  • NPI 1114954682
  Care Compare affiliation
• Champlain Valley Physicians Hospital Medical Center

  • General Acute Care Hospital
  • Plattsburgh, NY
  • NPI 1033270699
  Care Compare affiliation
• Elizabethtown Community Hospital

  dba Elizabethtown Community Hospital Transport

  • Ambulance
  • Elizabethtown, NY
  • NPI 1487923637

  Hospital

  Care Compare affiliation
• Elizabethtown Community Hospital

  • Critical Access Hospital
  • Elizabethtown, NY
  • NPI 1891785184
  Care Compare affiliation

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1356575369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FEATHERS DRIVE",
            "address_2": "CHAMPLAIN SPINE & PAIN MANAGEMENT",
            "city": "PLATTSBUGH",
            "state": "NY",
            "postal_code": "129010641",
            "telephone_number": "183-247-2465",
            "fax_number": "518-324-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FEATHERS DRIVE",
            "address_2": "CHAMPLAIN SPINE & PAIN MANAGEMENT",
            "city": "PLATTSBUGH",
            "state": "NY",
            "postal_code": "129010641",
            "telephone_number": "183-247-2465",
            "fax_number": "518-324-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "KELLY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013334",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Wayne Ackley, LPN

• Physician Assistant in Plattsbugh, NY
• Providers in Plattsbugh, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.