Individual provider Active NPI

Kaitlyn Grace Carmo, PA

  • Physician Assistant
  • Chester, PA
National Provider Identifier
1417608266
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA063247 Issued in PA
Practice address
1 Medical Center Blvd
Chester, PA 19013-3902
Phone
(717) 383-2818
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 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 MA063247 PA Primary

Addresses

Primary practice location

1 Medical Center Blvd
Chester, PA 19013-3902

Mailing address

1 Medical Center Blvd
Chester, PA 19013-3902
Phone (610) 876-2400

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
I20220124001789 PA Practitioner - Physician Assistant 6800288929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Practice addresses (Care Compare)

1703 S Broad St
Suite 300
Philadelphia, PA 19148-1536
Phone (215) 463-5333

404 McFarlan Rd
Suite 102
Kennett Square, PA 19348-2479
Phone (610) 696-2850

Hospital & facility affiliations

  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Merit-based Incentive Payment System (MIPS)

Final score
89.23 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
77.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063247PAMDPhysician 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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1417608266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-876-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "717-383-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMO",
        "first_name": "KAITLYN",
        "middle_name": "GRACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

Verify at the official NPI Registry.