Kelley W Jiang, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA058133 Issued in PA

Practice address

501 N Lansdowne Ave
Drexel Hill, PA 19026-1114

Phone

(610) 284-8100

NPI assigned

Feb 29, 2016

Last updated

Feb 29, 2016By 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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

On Demand Urgent Care Group PCGroup PAC ID 5991029712, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelley.jiang.1@14965.direct.athenahealth.com

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.

• On Demand Urgent Care Group PC

  dba On Demand Urgent Care

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1053729814
  Medicare reassignment Care Compare group
• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Prospect Health Access Network, Inc.

  • Infectious Disease Physician
  • Drexel Hill, PA
  • NPI 1659728178
  NPD
• On Demand Urgent Care Group PC

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1881083723
  NPD (past)

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1437519725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6718 SYLVESTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492216",
            "telephone_number": "917-346-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N LANSDOWNE AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190261114",
            "telephone_number": "610-284-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "KELLEY",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roopal Jani, RPH
• Je & Ji, Inc
• Jonas Jean-Claude
• Nyeesha Jean
• Jeremy Peres, PHD, PSYD, LLC
• Clement Joachim
• John J. Radomile and Mark G. Radomile PTR (Radomile Family Dental Care)
• Crystal Johnson
• Kristian Johnson
• Rebecca W Johnson, M.D.

• Physician Assistant in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.