Kelly Lee Drollette, NP
Individual provider Active NPI Nurse Practitioner · Peru, NY
NPI 1548895428 · NPPES record last updated Mar 31, 2023
Key facts
- NPI
- 1548895428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 347881 (NY)
- Practice address
- 3384 State Route 22 Ste 3
Peru, NY 12972-5305 - Phone
- (518) 643-8008
- Fax
- (518) 643-8090
- NPI assigned
- Mar 11, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwestern Medical Center Inc
Champlain Valley Physicians Hospital Medical Center
Practice addresses (Care Compare)
133 Fairfield St
Saint Albans, VT 05478-1726
75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000
Hospital & facility affiliations
- The University of Vermont Health Network - Champl
- Northwestern Medical Center Inc
- Elizabethtown Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210909002243 | NY | Practitioner - Nurse Practitioner | 5193121531 | Reassigns benefits to 2 organizations |
| I20260616000827 | VT | Practitioner - Nurse Practitioner | 5193121531 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 347881 | NY | MD | Nurse Practitioner |
| F347881 | NY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Binghamton University | Current |
Accepting new patients | |
| Champlain Valley Physicians Hospital Medical Center | Nurse Practitioner | Current |
Accepting new patients |
| Binghamton University Health Services | Past |
Accepting new patients |
Locations
75 Beekman St
Plattsburgh, NY 12901
Phone (518) 562-7100
206 Cornelia St
Plattsburgh, NY 12901
Phone (518) 561-5516
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | F347881 | NY | |
| Nurse Practitioner | 363L00000X | 347881 | NY | Yes |
Addresses
Primary practice location
3384 State Route 22 Ste 3
Peru, NY 12972-5305
Mailing address
4400 Vestal Pkwy E
Binghamton, NY 13902-4601
Other practice location 1
75 Beekman St
Plattsburgh, NY 12901-1438
Phone (518) 561-2000
Other practice location 2
206 Cornelia St
Plattsburgh, NY 12901-2878
Phone (518) 561-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 773557 | Other | NY | NEW YORK STATE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kdrolle1@binghamton.edu |
Other providers in Peru, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.