Individual provider Active NPI

Kelly Anne Santos

  • Family Nurse Practitioner
  • Hatboro, PA
National Provider Identifier
1528602158
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020008 Issued in PA
Practice address
3485 Davisville Rd
Hatboro, PA 19040-4220
Phone
(215) 830-0400
NPI assigned
Nov 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP020008 PA Primary

Addresses

Primary practice location

3485 Davisville Rd
Hatboro, PA 19040-4220

Mailing address

308 Crestwood Ave
Feasterville Trevose, PA 19053-2419
Phone (215) 913-7748

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191219000548 PA Practitioner - Nurse Practitioner 6305270695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-6698

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP020008PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Aug 20, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Aug 20, 2023 Accepting new patients
Tower Health Urgent Care, LLC CurrentSince Nov 1, 2021 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Aug 13, 2021 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

L2540
Columbus, OH 43260

1139 Ben Franklin Hwy W
Ste 114
Douglassville, PA 19518
Phone (610) 385-4444

3485 Davisville Rd
Hatboro, PA 19040
Phone (215) 830-0400

3430 Huntingdon Pike
Huntingdon Vy, PA 19006
Phone (215) 938-7171

33 W Ridge Pike
Ste 627
Royersford, PA 19468
Phone (610) 226-6200

520 Chestnut St
Bldg S3
West Reading, PA 19611
Phone (610) 561-6320

Organizations & group practices 5

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 3

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.

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1528602158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CRESTWOOD AVE",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190532419",
            "telephone_number": "215-913-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 DAVISVILLE RD",
            "city": "HATBORO",
            "state": "PA",
            "postal_code": "190404220",
            "telephone_number": "215-830-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hatboro, PA

Sources for this page

Verify at the official NPI Registry.