Shane Kalette, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA063045 Issued in PA

Practice address

6 E Lancaster Ave Uppr Level
Wynnewood, PA 19096-3430

Phone

(484) 380-2808

Fax

(484) 416-3942

NPI assigned

Oct 27, 2021

Last updated

Aug 12, 2025By the provider in NPPES

Sex

Male

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bryn Mawr Medical Specialists Association

  • Multi-Specialty Clinic/Center
  • Bryn Mawr, PA
  • NPI 1841226099
  Medicare reassignment
• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  NPD (past)

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1528722469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD STE 320",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103235",
            "telephone_number": "610-527-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E LANCASTER AVE UPPR LEVEL",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963430",
            "telephone_number": "484-380-2808",
            "fax_number": "484-416-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALETTE",
        "first_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-27",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akhnuwkh Jones, M.D.
• Jonathan Michael Josse, MD
• Jenny Bola Jung, DO
• K2 Osteopathic, LLC (Arcana Center for Integrative Medicine)
• Neal K Kalantri, MD
• Emmanouil Kalfagiannis, MD
• Shelia Parvin Kambin, M.D.
• Dora Kamensky Batori, CRNA
• Kathryn Kaminski, MD
• Matthew Kaminski, CRNP

• Physician Assistant in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.