Kelley Marie Dickson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS022928 Issued in PA

Practice address

1260 E. Woodland Ave
Ste 200
Springfield, PA 19064-3956

Phone

(610) 690-4490

Fax

(610) 328-9391

NPI assigned

Apr 2, 2020

Last updated

Dec 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clinical Specialty AssociatesGroup PAC ID 5799295853, 165 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Clinical Specialty Associates

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Bala Cynwyd, PA
  • NPI 1184431900
  Medicare reassignment Care Compare group NPD (past)
• Chespenn Health Services

  • Federally Qualified Health Center (FQHC)
  • Chester, PA
  • NPI 1750329603
  Medicare reassignment NPD
• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Clinical Specialty Associates

  • Infectious Disease Physician
  • Bala Cynwyd, PA
  • NPI 1932992609
  NPD
• Clinical Specialty Associates

  • Gastroenterology Physician
  • Bala Cynwyd, PA
  • NPI 1992595763
  NPD
• Prospect Health Access Network, Inc.

  • Neurology Physician
  • Chester, PA
  • NPI 1013364520
  NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797

  Family Medicine

  NPD
• Chespenn Health Services

  • Federally Qualified Health Center (FQHC)
  • Upper Darby, PA
  • NPI 1225272263
  NPD (past)

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

• Hospital of the University of PA

  • Ambulatory Fertility Facility
  • Phila, PA
  • NPI 1033262316

  Hospital

  Care Compare affiliation
• Trustees of the University of Pennsylvania

  dba Hospital of the University of Pennsylvania

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1851370910
  Care Compare affiliation

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1366071425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 E. WOODLAND AVE",
            "address_2": "STE 200",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643956",
            "telephone_number": "610-690-4490",
            "fax_number": "610-328-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E. WOODLAND AVE",
            "address_2": "STE 200",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643956",
            "telephone_number": "610-690-4490",
            "fax_number": "610-328-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "KELLEY",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS022928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Desantis
• Kathleen Devine Fox, PA
• Tess Elizabeth Devlieger, PHARMD
• Lawrence A Dibello, RPH
• Allison Dicicco
• Kylie Anne Digiacomo
• Digitrace Care Services Inc
• Marko Dimiskovski, DO
• Anthony Dinardo, D.C.
• Gabriella Aurora Dipasquale, OTR/L

• Family Medicine Physician in Springfield, PA
• Providers in Springfield, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.