NPIMap

Individual provider Active NPI

Kelly G Passarello, PA-C

  • Adult Medicine Physician
  • Summerville, SC
National Provider Identifier
1639449697
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
1710 Issued in SC
Practice address
87 Springview LN
Summerville, SC 29485-9077
Phone
(843) 876-7979
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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 PA08170 TX
Adult Medicine Physician 207QA0505X 1710 SC Primary

Addresses

Primary practice location

87 Springview LN
Summerville, SC 29485-9077

Mailing address

PO Box 602108
Charlotte, NC 28260-2108

Other names 1

  • Kelly Elizabeth Gleffe Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20221208000329 SC Practitioner - Physician Assistant 2163661885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Family Care IncGroup PAC ID 4587557731, 81 clinicians

Practice addresses (Care Compare)

1208 Two Island CT
Mount Pleasant, SC 29466-7436
Phone (843) 884-6653

2000 1St Ave
Summerville, SC 29486-0408
Phone (843) 876-7930

87 Springview LN
Summerville, SC 29485-9077
Phone (843) 876-7979

Hospital & facility affiliations

  • Musc Health at Home, by Bayada- Charleston Home health agency, Charleston, SC, CCN 427004
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

Merit-based Incentive Payment System (MIPS)

Final score
93.96 of 100Reported as group
Quality
89.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA08170TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince Jan 14, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol Physician Assistant CurrentSince Oct 12, 2022 Accepting new patients
Carolina Family Care, Inc CurrentSince Jan 14, 2024 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Oct 12, 2022 Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653

87 Springview Ln
Summerville, SC 29485
Phone (843) 876-7979

Interoperability endpoints

  • Direct secure messaging: kpassarello412404@direct.musc.edu

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": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1639449697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 SPRINGVIEW LN",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294859077",
            "telephone_number": "843-876-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSARELLO",
        "first_name": "KELLY",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08170",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "SC",
            "license": "1710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "87 Springview Ln",
            "city": "Summerville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294859077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GLEFFE",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.