Individual provider Active NPI

Kip M. Peeler, PA-C

  • Medical Physician Assistant
  • State College, PA
National Provider Identifier
1649233446
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA001873L Issued in PA
Practice address
1850 E Park Ave
Suite 201
State College, PA 16803-6706
Phone
(814) 234-8800
Fax
(814) 235-1133
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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 MA001873L PA Primary

Addresses

Primary practice location

1850 E Park Ave
Suite 201
State College, PA 16803-6706

Mailing address

1850 E Park Ave
Suite 201
State College, PA 16803-6706
Phone (814) 234-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050719001077 PA Practitioner - Physician Assistant 4880621069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Nittany Medical Center Health Services IncGroup PAC ID 8426136797, 366 clinicians

Practice addresses (Care Compare)

1061 N Front St
2 Mount Nittany Physician Group
Philipsburg, PA 16866-8257
Phone (814) 376-6200

129 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-3626

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

143 Hospital Dr
State College, PA 16803-5500
Phone (814) 237-3470

155 Wellness Way
State College, PA 16803-6702

155 Wellness Way
State College, PA 16803-6797
Phone (814) 231-7000

3631 Penns Valley Rd
Spring Mills, PA 16875-8011
Phone (814) 422-8873

Hospital & facility affiliations

  • Mount Nittany Medical Center Hospital, State College, PA, CCN 390268

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc Medical CurrentSince Jan 5, 2011 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

1061 N Front St
Ste 2
Philipsburg, PA 16866
Phone (814) 231-7888

96 Kish Rd
Reedsville, PA 17084
Phone (717) 667-7720

1850 E Park Ave
#201
State College, PA 16803
Phone (814) 234-8800

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

143 Hospital Dr
Ste 302
State College, PA 16803
Phone (814) 278-4680

143 Hospital Dr
Ste 201
State College, PA 16803
Phone (814) 689-3140

1850 E Park Ave
State College, PA 16803
Phone (814) 234-6750

Organizations & group practices 2

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 5

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1649233446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-8800",
            "fax_number": "814-235-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-8800",
            "fax_number": "814-235-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEELER",
        "first_name": "KIP",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA001873L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.