Kelly M. Distelrath, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP022823 Issued in PA

Practice address

3601 McKnight East Dr
Pittsburgh, PA 15237-6400

Phone

(412) 369-9943

Fax

(412) 369-9447

NPI assigned

Oct 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Genesis Medical Associates, Inc.Group PAC ID 7113814104, 99 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Genesis Medical Associates, Inc.

  • Family Medicine Physician
  • Pittsburgh, PA
  • NPI 1205905429
  Medicare reassignment Care Compare group NPD
• Genesis Medical Associates, Inc.

  • Clinical Medical Laboratory
  • Pittsburgh, PA
  • NPI 1730339615
  NPD

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1477151280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 PERRY HWY STE 201",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152375200",
            "telephone_number": "724-741-0044",
            "fax_number": "412-369-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 MCKNIGHT EAST DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152376400",
            "telephone_number": "412-369-9943",
            "fax_number": "412-369-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTELRATH",
        "first_name": "KELLY",
        "middle_name": "M.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0027728",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103876840-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Lynn Disimo, BSN
• Disintegration Therapy, LLC
• Linda Diskin
• Diskriter, Inc.
• Aislinn Disomma, DPT
• Alexandra Ditchkus
• Michael F Ditillo, DO
• Michele Ann Ditommaso, APRN, BC
• Alison Dittmer, PHARMD
• Nicholas P Ditullio, MD

• Family Nurse Practitioner in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.