Kelly Nicole Champion, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4354 Issued in MA

Practice address

199 Reedsdale Rd
Milton, MA 02186-3926

Phone

(617) 696-4600

NPI assigned

Feb 10, 2012

Last updated

Apr 10, 2018By the provider in NPPES

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

Other names 1

• Kelly Nicole Champion Former name

Medicare fee-for-service enrollment

Enrolled in MA

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

Community Physicians Associates IncGroup PAC ID 7315931482, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kchampion255376@direct.bilh.masshiway.net

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.

• Community Physicians Associates, Inc.

  • Orthopaedic Surgery Physician
  • Milton, MA
  • NPI 1477832780
  Medicare reassignment Care Compare group
• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment NPD
• Community Physicians Associates, Inc.

  • Family Medicine Physician
  • Milton, MA
  • NPI 1538154869
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beth Israel Deaconess Hospital Milton Inc

  • General Acute Care Hospital
  • Milton, MA
  • NPI 1174618953
  Care Compare affiliation

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1578836219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 FRANKFORT ST # 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021283114",
            "telephone_number": "978-697-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 REEDSDALE RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021863926",
            "telephone_number": "617-696-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CHAMPION",
            "middle_name": "NICOLE",
            "credential": "MPAS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catanco Inc. (Commonwealth Home Care, Inc.)
• Peter K Cellucci, M.D.
• Center for Therapy and Healing
• Lori A Cetrino, CRNA
• Michele T Chabot, MD
• Amanda Sue Chapin, LMHC
• Charlotte J Richards MD PC (Charlotte J Richards MD)
• James Chen
• Lisa A Cheney, MSPT
• Hans Chiang, MD, MBA, MS

• Physician Assistant in Milton, MA
• Providers in Milton, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.