NPIMap

Individual provider Active NPI

Kelly Loren McCullough, PA-C

  • Medical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1497088025
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051371 Issued in PA
Practice address
9104 Babcock Blvd
Suite 2120
Pittsburgh, PA 15237-5818
Phone
(412) 367-0600
Fax
(412) 367-7079
NPI assigned
Sep 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051371 PA Primary

Addresses

Primary practice location

9104 Babcock Blvd
Suite 2120
Pittsburgh, PA 15237-5818

Mailing address

7500 Brooktree Road
Suite 320
Wexford, PA 15090-5818
Phone (412) 367-0600

Other identifiers 37

IdentifierTypeStateIssuer
1497088025OtherAETNA BETTER HEALTH
1497088025OtherCORVEL
1497088025OtherHIGHMARK MANAGED CARE
1497088025OtherUNITED HEALTHCARE/OPTUM
1497088025OtherAETNA MEDICARE
1497088025OtherDEVON
1497088025OtherGEISINGER MEDICARE
1497088025OtherKEYSTONE MANAGED CARE
1497088025OtherHPUOV
1497088025OtherUPMC COMMERCIAL
1497088025OtherUNISON OF OH
1497088025MedicaidPA
1490788025OtherGATEWAY MEDICARE ASSURED
1497088025OtherHIGHMARK BLUE SHIELD
1497088025OtherFLORA
1497088025OtherGATEWAY HEALTH PLAN
1497088025OtherGREAT WEST
1497088025OtherUNITED HEALTHCARE/UNISON
1497088025OtherCIGNA
1497088025OtherCIGNA BEHAVIORAL HEALTH
1497088025OtherHUMANA COMMERCIAL
1497088025OtherMEDICARE-NOVITAS
1497088025OtherPRIVATE HEALTH CARE SYSTEM
1497088025OtherAETNA COMMERCIAL
1497088025OtherGEISINGER HEALTH
1497088025OtherINTERGROUP
1497088025OtherWEXFORD HEALTH SERVICES
1497088025OtherAMERIHEALTH MERCY
1497088025OtherFIDELIS CARE MA
1497088025OtherCOMMUNITY LIFE
1497088025OtherFIDELIS CARE MEDICARE
1497088025OtherHEALTH AMERICA
1497088025OtherPALMETTO--RAILROAD MEDICARE
1497088025OtherUNITED HEALTHCARE COMMERCIAL
1497088025OtherUPMC FOR LIFE
1497088025OtherUPMC FOR YOU
1497088025OtherVANTAGE PPO

Other names 1

  • Kelly Loren Heffner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100308000008 PA Practitioner - Physician Assistant 1052456613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upmc Multispecialty Group IncGroup PAC ID 7315263621, 57 clinicians

Practice addresses (Care Compare)

6998 Crider Rd
Suite 110
Mars, PA 16046-2390
Phone (866) 874-7483

9104 Babcock Blvd
Suite 2120
Pittsburgh, PA 15237-5818
Phone (866) 874-7483

Hospital & facility affiliations

  • Independence Health System Butler Memorial Hospita Hospital, Butler, PA, CCN 390168
  • Heritage Valley Beaver Hospital, Beaver, PA, CCN 390036
  • Upmc Jameson Hospital, New Castle, PA, CCN 390016
  • Upmc Horizon Hospital, Greenville, PA, CCN 390178

Merit-based Incentive Payment System (MIPS)

Final score
83.85 of 100Reported as group
Quality
69.17
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051371PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kelly.mccullough@upmcdirect.com

Organizations & group practices 2

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 11

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.

{
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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1497088025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 BROOKTREE ROAD",
            "address_2": "SUITE 320",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150905818",
            "telephone_number": "412-367-0600",
            "fax_number": "412-367-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 BABCOCK BLVD",
            "address_2": "SUITE 2120",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152375818",
            "telephone_number": "412-367-0600",
            "fax_number": "412-367-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KELLY",
        "middle_name": "LOREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051371",
            "primary": true
        }
    ],
    "identifiers": [
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        {
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            "state": null
        },
        {
            "code": "01",
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            "issuer": "HPUOV",
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        {
            "code": "05",
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            "state": "PA"
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        {
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            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1490788025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
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            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORA",
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            "state": null
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "1497088025",
            "state": null
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE/UNISON",
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            "state": null
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
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            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
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            "issuer": "HUMANA COMMERCIAL",
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            "state": null
        },
        {
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            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTH CARE SYSTEM",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA COMMERCIAL",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERGROUP",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
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            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE MA",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY LIFE",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE MEDICARE",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO--RAILROAD MEDICARE",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE COMMERCIAL",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC FOR  LIFE",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC FOR YOU",
            "identifier": "1497088025",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VANTAGE PPO",
            "identifier": "1497088025",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "HEFFNER",
            "middle_name": "LOREN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.