Active NPI
Kelly P McNulty, PA
- Medical Physician Assistant
- York, PA
National Provider Identifier
1518116359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA053684
- Practice address
- 205 Saint Charles Way
York, PA 17402-4643 - Phone
- (717) 741-4666
- Fax
- (717) 741-9649
- NPI assigned
- Sep 17, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA053684 | PA | Primary |
Addresses
Primary practice location
205 Saint Charles Way
York, PA 17402-4643
Mailing address
205 Saint Charles Way
York, PA 17402-4643
Phone (717) 741-4666
Other practice location 1
525 McCosh St
Hanover, PA 17331-2238
Phone (717) 632-2711
Other practice location 2
246 Hanover St
Gettysburg, PA 17325-1911
Phone (717) 334-2811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2696616 | Other | PA | HIGHMARK BLUE SHIELD - FREEDOM BLUE |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
205 Saint Charles Way
York, PA 17402-4643
Phone (717) 741-4666
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.05 of 100
- Quality
- 100
- Promoting interoperability
- 93
- Improvement activities
- 40
- Cost
- 82.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Wellspan Medical Group | Past | Accepting new patients |
Interoperability endpoints
- kmcnulty@dermyork.medentdirect.com
Organizations & group practices 3
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.
-
- Dermatology Physician
- York, PA
- NPI 1245204023
-
- Pediatric Surgery Physician
- York, PA
- NPI 1104799428
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Gettysburg, PA
- NPI 1265466957
-
- General Acute Care Hospital
- York, PA
- NPI 1326060492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740096000000",
"number": "1518116359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 SAINT CHARLES WAY",
"city": "YORK",
"state": "PA",
"postal_code": "174024643",
"telephone_number": "717-741-4666",
"fax_number": "717-741-9649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 SAINT CHARLES WAY",
"city": "YORK",
"state": "PA",
"postal_code": "174024643",
"telephone_number": "717-741-4666",
"fax_number": "717-741-9649"
}
],
"practiceLocations": [
{
"address_1": "525 McCosh St",
"address_purpose": "LOCATION",
"city": "Hanover",
"state": "PA",
"postal_code": "173312238",
"country_code": "US",
"telephone_number": "717-632-2711",
"fax_number": "717-741-9649",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "246 Hanover St",
"address_purpose": "LOCATION",
"city": "Gettysburg",
"state": "PA",
"postal_code": "173251911",
"country_code": "US",
"telephone_number": "717-334-2811",
"fax_number": "717-741-9649",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCNULTY",
"first_name": "KELLY",
"middle_name": "P",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-17",
"last_updated": "2025-02-21",
"certification_date": "2025-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA053684",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD - FREEDOM BLUE",
"identifier": "2696616",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.
- 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.