NPIMap

Individual provider Active NPI

Chelsey Renee Zimmerman, PA-C

  • Medical Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1619333440
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA058043 Issued in PA
Practice address
4815 Liberty Ave Ste 310
Pittsburgh, PA 15224-2156
Phone
(412) 578-1116
Fax
(412) 605-6396
NPI assigned
Jan 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OA003722 PA
Medical Physician Assistant 363AM0700X MA058043 PA Primary

Addresses

Primary practice location

4815 Liberty Ave Ste 310
Pittsburgh, PA 15224-2156

Mailing address

4815 Liberty Ave Ste 310
Pittsburgh, PA 15224-2156
Phone (412) 578-1116

Other identifiers 1

IdentifierTypeStateIssuer
103191590MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address czimmerman251295@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160408000480 PA Practitioner - Physician Assistant 4880992759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glade Run Medical Associates IncGroup PAC ID 3577696897, 27 clinicians

Practice addresses (Care Compare)

1 Nolte Dr
Kittanning, PA 16201-7111

77 Glade Dr
Kittanning, PA 16201-7140
Phone (724) 545-2205

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA003722PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Glade Run Medical Associates CurrentSince Jan 6, 2022 Accepting new patients
Glade Run Medical Associates Inc CurrentSince Jan 6, 2022 Accepting new patients
Upmc Altoona Past Accepting new patients
Glade Run Medical Associates Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

77 Glade Dr
Kittanning, PA 16201
Phone (724) 545-2205

700 Medical Arts Bldg
Ste 710
Kittanning, PA 16201
Phone (724) 543-8626

200 Medical Arts Bldg
Ste 230
Kittanning, PA 16201
Phone (724) 543-8784

1 Nolte Dr
Kittanning, PA 16201
Phone (724) 543-8109

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1619333440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 310",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-578-1116",
            "fax_number": "412-605-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 LIBERTY AVE STE 310",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152242156",
            "telephone_number": "412-578-1116",
            "fax_number": "412-605-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "CHELSEY",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-08",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003722",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA058043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103191590",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "czimmerman251295@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4815 Liberty Ave Ste 310",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152242156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.