Kelly Dallas, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00300900 Issued in NJ

Practice address

131 Route 70 Ste 100a
Medford, NJ 08055-9501

Phone

(609) 267-9400

Fax

(609) 451-5518

NPI assigned

Dec 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057

Merit-based Incentive Payment System (MIPS)

Final score

81.15 of 100Reported as group

Quality

62.28

Promoting interoperability

100

Improvement activities

40

Cost

74.89

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdallas18281@directvirtua.org

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment Care Compare group NPD (past)
• Virtua Medical Group, PA

  • Urgent Care Clinic/Center
  • Moorestown, NJ
  • NPI 1184174849
  NPD
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988

  Physician Assistant

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Virtua - Memorial Hospital Burlington County, Inc.

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation
• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  Care Compare affiliation

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1497091193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ROUTE 70 STE 100A",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559501",
            "telephone_number": "609-267-9400",
            "fax_number": "609-451-5518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "243 US Highway 130 Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bordentown",
            "state": "NJ",
            "postal_code": "085052137",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "609-424-3517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W Route 38 Ste A",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573424",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "856-234-3921",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Route 70 E",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342408",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "856-488-5709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2103 Mount Holly Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NJ",
            "postal_code": "080164157",
            "country_code": "US",
            "telephone_number": "609-747-9200",
            "fax_number": "609-747-1408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Bowman Dr Ste E100",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439648",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "856-809-2334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "994 W Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606937",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "856-696-2214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "570 Egg Harbor Rd Ste C4-A",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080802359",
            "country_code": "US",
            "telephone_number": "609-267-9400",
            "fax_number": "856-270-2786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00300900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne A Cullen
• Michelle Cwanger, L.C.S.W
• Karen Cybulsky, M.ED, LPC
• Louis A D'Angelo, DMD
• Glenn H. Daehnke, CPED
• James Charles Damico, DO
• Megan Elizabeth Danial
• Karen Fung Dante, M.D.
• David a. High
• David R. McComb, DO, LLC

• Physician Assistant in Medford, NJ
• Providers in Medford, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; 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.