Kelly Christine Mutsavage, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MA052475 Issued in PA

Practice address

640 Alden St
Meadville, PA 16335-2348

Phone

(814) 724-1252

Fax

(814) 333-8871

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ucmg LLCGroup PAC ID 6709398969, 254 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.89 of 100Reported as group

Quality

65.8

Promoting interoperability

100

Improvement activities

40

Cost

73.83

Merit-based Incentive Payment System (MIPS)

Final score

99 of 100Reported as group

Quality

95.9

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmutsavage20843@gohealthupmc.direct-ci.com

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.

• Ucmg LLC

  • Urgent Care Clinic/Center
  • Allison Park, PA
  • NPI 1972300622
  Medicare reassignment Care Compare group
• Primary Care Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
  • NPI 1487724084
  Medicare reassignment NPD
• Ahn Emergency Group of Pittsburgh LTD.

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1043635402
  Medicare reassignment
• Ahn Emergency Group of West Penn LTD.

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1033534490
  Medicare reassignment
• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654
  Medicare reassignment
• Urgent Care, PC - Pennsylvania

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1982839031
  Medicare reassignment
• Medexpress Urgent Care, PC - Pennsylvania

  • Urgent Care Clinic/Center
  • Lancaster, PA
  • NPI 1700188257
  NPD
• Medexpress Urgent Care, PC - Pennsylvania

  • Urgent Care Clinic/Center
  • Saint Clair, PA
  • NPI 1720545320
  NPD
• Primary Care Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pittsburgh, PA
  • NPI 1326815754
  NPD
• PA Liberty St Emergency Physicians LLC

  • Emergency Medicine Physician
  • Meadville, PA
  • NPI 1457774937

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1487601886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ALDEN ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352348",
            "telephone_number": "814-724-1252",
            "fax_number": "814-333-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ALDEN ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352348",
            "telephone_number": "814-724-1252",
            "fax_number": "814-333-8871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Freeport Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Aspinwall",
            "state": "PA",
            "postal_code": "152152976",
            "country_code": "US",
            "telephone_number": "412-782-3278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUTSAVAGE",
        "first_name": "KELLY",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MA052475",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052475",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MA052475",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikala Mosley
• Mount Hope Home Care, LLC
• Nicholas J Mulhearn, D.O.
• Gregory R Murray, DO
• Amanda Mushrush, LPC
• Alexis May Myers, RN
• Sarah Jaslyn Myles, OD
• Matthew Nagel, MA, LPC
• National Birth Centers, Inc.
• Neighborhood Counseling Services LLC

• Dermatology Physician in Meadville, PA
• Providers in Meadville, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.