Individual provider Active NPI

Corinna Jay Kirkpatrick, PA-C

  • Medical Physician Assistant
  • Scranton, PA
National Provider Identifier
1609145309
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA055355 Issued in PA
Practice address
1141 Moosic St
Scranton, PA 18505-2105
Phone
(570) 348-1101
Fax
(570) 348-6194
NPI assigned
Dec 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA055355 PA Primary

Addresses

Primary practice location

1141 Moosic St
Scranton, PA 18505-2105

Mailing address

130 Carol Dr
Clarks Summit, PA 18411-1922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20200514002115 MD Practitioner - Physician Assistant 5890078729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
70.92
Promoting interoperability
98
Improvement activities
40
Cost
71.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic General Hospital Corp CurrentSince Mar 1, 2020 Accepting new patients
Atlantic Immedicare LLC Past Accepting new patients

Locations

10026 Old Ocean City Blvd
Ste 1
Berlin, MD 21811

9714 Healthway Dr
Berlin, MD 21811
Phone (410) 641-2600

11107 Racetrack Rd
Ocean Pnes, MD 21811
Phone (410) 208-9761

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1609145309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CAROL DR",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 MOOSIC ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185052105",
            "telephone_number": "570-348-1101",
            "fax_number": "570-348-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "CORINNA",
        "middle_name": "JAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-26",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.