Active NPI
Kelly Senour, PA-C
- Surgical Physician Assistant
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- MA066023
- Practice address
- 3400 Spruce Street
3 Silverstein BLDG
Philadelphia, PA 19104-4206 - Phone
- (215) 662-3487
- NPI assigned
- Oct 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 25MP00890500 | NJ | |
| Surgical Physician Assistant | 363AS0400X | MA066023 | PA | Primary |
Addresses
Primary practice location
3400 Spruce Street
3 Silverstein BLDG
Philadelphia, PA 19104-4206
Mailing address
3400 Spruce Street
3 Silverstein BLDG
Philadelphia, PA 19104-4206
Other practice location 1
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone (609) 832-5060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00890500 | NJ | MD | Surgical Physician Assistant |
| MA066023 | PA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Penn-Medical Group | Current | Accepting new patients | |
| Clinical Health Care Associates of New Jersey, PC | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Clinical Health Care Associates of New Jersey, P.C. | Current | Accepting new patients |
Locations
1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500
3205 Fire Rd
Egg Hbr Twp, NJ 08234
Phone (609) 407-1113
3400 Spruce St
Fl 3
Philadelphia, PA 19104
3400 Convention Ave
Philadelphia, PA 19104
Phone (215) 662-2300
Organizations & group practices 6
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.
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-
- Surgical Oncology Physician
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- NPI 1871981985
-
- Family Medicine Physician
- Cherry Hill, NJ
- NPI 1447260435
-
- Diagnostic Radiology Physician
- Cherry Hill, NJ
- NPI 1821447103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744329600000",
"number": "1508686205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE STREET",
"address_2": "3 SILVERSTEIN BLDG",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE STREET",
"address_2": "3 SILVERSTEIN BLDG",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044206",
"telephone_number": "215-662-3487"
}
],
"practiceLocations": [
{
"address_1": "3400 Civic Center Blvd",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191045127",
"country_code": "US",
"telephone_number": "609-832-5060",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SENOUR",
"first_name": "KELLY",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-16",
"last_updated": "2025-04-11",
"certification_date": "2025-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NJ",
"license": "25MP00890500",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "PA",
"license": "MA066023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.