Cristin Maura Kelly, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00337900 Issued in NJ

Practice address

390 Route 10 W
Suite 102
Randolph, NJ 07869-2141

Phone

(973) 366-6303

NPI assigned

Jul 8, 2014

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Natural Image Skin CenterGroup PAC ID 1557502390, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.75 of 100Reported as group

Quality

76.52

Promoting interoperability

100

Improvement activities

40

Cost

75.97

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Natural Image Skin Center

  • Dermatology Physician
  • Hackettstown, NJ
  • NPI 1730427030
  Medicare reassignment Care Compare group
• The Radiology Group of New Jersey, LLC

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1538575766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 WOODSIDE AVE",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078602313",
            "telephone_number": "973-300-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 ROUTE 10 W",
            "address_2": "SUITE 102",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692141",
            "telephone_number": "973-366-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CRISTIN",
        "middle_name": "MAURA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00337900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis Mona Kaplan, M.S.W., L.C.S.W.
• Randi Karol
• Karen C Kaspern, LPC
• Lindsay Elizabeth Kellogg, APN
• Catherine L Kelly, MSPT
• Michael E Kelly, LCSW
• Yelena Khaysman, MD
• Amanda Faith Kielbania, LCSW
• Yvonne Kiernan
• Grace G Kim, D.P.T.

• Medical Physician Assistant in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.