Individual provider Active NPI

Kelli Regenbaum, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1487282158
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3737 Market St
Philadelphia, PA 19104-5545
Phone
(215) 662-3340
Fax
(267) 369-4809
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 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 Primary

Addresses

Primary practice location

3737 Market St
Philadelphia, PA 19104-5545

Mailing address

3737 Market St
Philadelphia, PA 19104-5545
Phone (215) 662-3340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210608002794 PA Practitioner - Physician Assistant 5496155723 Reassigns benefits to 2 organizations
I20231130002092 NJ Practitioner - Physician Assistant 5496155723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians
Clinical Health Care Associates of New Jersey PCGroup PAC ID 0749180198, 793 clinicians
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

145 King of Prussia Rd
Radnor, PA 19087-4557

145 King of Prussia Rd 201
Radnor, PA 19087-4557

145 King of Prussia Rd 203
Radnor, PA 19087-4557

145 King of Prussia Rd 302
GYN/Onc Radnor
Radnor, PA 19087-4557
Phone (610) 902-2500

145 King of Prussia Rd N
G102 Oto Surgery Radnor
Philadelphia, PA 19087-4557
Phone (610) 902-5500

145 King of Prussia Rd N G
1 Rad Onc Rdanor
Radnor, PA 19087-4557
Phone (610) 902-4580

145 King of Prussia Road G-103
Oral/Maxillo Surg Radnor
Radnor, PA 19087-4557
Phone (610) 902-2100

1865 Route 70 E 220
Mus Skel Cherry Hill
Cherry Hill, NJ 08003-2013
Phone (856) 429-0505

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

51 N 39TH St
Philadelphia, PA 19104-2640

51 N 39TH Street
Gi Surgery PPMC
Philadelphia, PA 19104-2640
Phone (215) 662-9198

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226
  • Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
79.04
Promoting interoperability
99
Improvement activities
40
Cost
82.85

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Nov 15, 2024 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Nov 15, 2024 Accepting new patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Oct 20, 2023 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Jul 6, 2021 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Oct 20, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince May 31, 2024 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Jul 6, 2021 Accepting new patients

Locations

999 Route 73 N
Ste 401
Marlton, NJ 08053

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

1118 W Baltimore Pike
Media, PA 19063
Phone (484) 931-2270

1118 W Baltimore Pike
#43
Media, PA 19063

3737 Market St
Fl 6
Philadelphia, PA 19104
Phone (215) 294-9150

3737 Market St
Philadelphia, PA 19104
Phone (215) 294-9393

3737 Market St
Fl 8
Philadelphia, PA 19104
Phone (215) 662-4333

PO B0x 824320
Philadelphia, PA 19182

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Organizations & group practices 8

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 6

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": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1487282158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045545",
            "telephone_number": "215-662-3340",
            "fax_number": "267-369-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045545",
            "telephone_number": "215-662-3340",
            "fax_number": "267-369-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGENBAUM",
        "first_name": "KELLI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.