Individual provider Active NPI

Megan J. Kelly, PA-C

  • Physician Assistant
  • Pittston, PA
National Provider Identifier
1407816184
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA003093L Issued in PA
Practice address
42 N Main St
Pittston, PA 18640-1916
Phone
(570) 654-0880
Fax
(570) 655-9857
NPI assigned
Mar 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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 MA003093L PA Primary

Addresses

Primary practice location

42 N Main St
Pittston, PA 18640-1916

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkelly74756@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040712001432 PA Practitioner - Physician Assistant 9830177161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

42 N Main St
Pittston, PA 18640-1916
Phone (570) 654-0880

499 Wyoming Ave
Kingston, PA 18704-3602
Phone (570) 283-2161

560 Pierce St
Kingston, PA 18704-5716
Phone (570) 714-5810

57 N Main St
Geisinger Medical Group Pittston
Pittston, PA 18640-1915
Phone (570) 654-0880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA003093LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Sep 5, 2000 Accepting new patients
Geisinger-HM Joint Venture LLC CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic CurrentSince Sep 5, 2000 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

174 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

226 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

224 N Logan Blvd
Burnham, PA 17009
Phone (717) 242-0196

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

114 Lt Michael Cleary Dr
Dallas, PA 18612
Phone (570) 255-1178

100 N Academy Ave
Danville, PA 17822

499 Wyoming Ave
Kingston, PA 18704
Phone (570) 283-2161

560 Pierce St
Kingston, PA 18704
Phone (570) 283-2161

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

68 Spring St
Lock Haven, PA 17745
Phone (570) 263-5830

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

4004 Birney Ave
Moosic, PA 18507
Phone (570) 344-4711

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

128 E Main St
Nanticoke, PA 18634
Phone (570) 258-1304

42 N Main St
Pittston, PA 18640
Phone (570) 602-5610

57 N Main St
Pittston, PA 18640
Phone (570) 602-5620

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

1630 N Atherton St
State College, PA 16803
Phone (814) 238-1279

50 Roosevelt Ter
Wilkes Barre, PA 18702
Phone (570) 808-8780

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

Interoperability endpoints

  • Direct secure messaging: mkelly74756@direct.geisinger.edu

Organizations & group practices 7

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1407816184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223034",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 N MAIN ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186401916",
            "telephone_number": "570-654-0880",
            "fax_number": "570-655-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MEGAN",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-25",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003093L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkelly74756@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "42 N Main St",
            "city": "Pittston",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186401916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

Verify at the official NPI Registry.