Individual provider Active NPI

Kelsey Nicole Muchmore, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1467051821
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.006594RX Issued in OH
Practice address
3200 Burnet Ave
Cincinnati, OH 45229-3019
Phone
(513) 475-7505
Fax
(513) 475-7355
NPI assigned
Oct 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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 50.006594RX OH Primary

Addresses

Primary practice location

3200 Burnet Ave
Cincinnati, OH 45229-3019

Mailing address

PO Box 636256
Cincinnati, OH 45263-6256
Phone (513) 246-1964

Other practice location 1

10600 Montgomery Rd Ste 300
Montgomery, OH 45242-4464
Phone (513) 853-9250

Other identifiers 1

IdentifierTypeStateIssuer
0459280MedicaidOH

Other names 1

  • Kelsey Nicole Weiss Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210923001190 OH Practitioner - Physician Assistant 3274930904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

3229 Burnet Ave
Cincinnati, OH 45229-3018
Phone (513) 584-4268

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.006594RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Physician Assistant CurrentSince Oct 1, 2023 Accepting new patients
University of Cincinnati Medical Center, LLC Physician Assistant Current Accepting new patients
Trihealth Physician Institute Physician Assistant Past Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3200 Burnet Ave
Cincinnati, OH 45229
Phone (513) 558-7700

3200 Burnet Ave
#2
Cincinnati, OH 45229
Phone (513) 585-5505

915 Michigan St
Ste 100
Sidney, OH 45365
Phone (937) 419-8049

Organizations & group practices 3

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 2

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": "1602979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1467051821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-246-1964",
            "fax_number": "513-245-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293019",
            "telephone_number": "513-475-7505",
            "fax_number": "513-475-7355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10600 Montgomery Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "OH",
            "postal_code": "452424464",
            "country_code": "US",
            "telephone_number": "513-853-9250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUCHMORE",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-18",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006594RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0459280",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "WEISS",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.