Nicholas Aaron Kilpatrick, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA061942 Issued in PA

Practice address

1100 Grampian Blvd
Williamsport, PA 17701-1907

Phone

(570) 320-7444

Fax

(570) 320-7445

NPI assigned

Mar 6, 2007

Last updated

Nov 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Susquehanna Physician Services

  dba Susquehanna Health Medical Group

  • Occupational Medicine Physician
  • Williamsport, PA
  • NPI 1134455967

  Physician Assistant

  Medicare reassignment NPD
• Susquehanna Physician Services

  • Radiology Clinic/Center
  • Mansfield, PA
  • NPI 1073361564
  NPD
• Susquehanna Physician Services

  dba Susquehanna Health Medical Group

  • Family Medicine Physician
  • South Williamsport, PA
  • NPI 1780631226
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1649300864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-326-8723",
            "fax_number": "570-326-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011907",
            "telephone_number": "570-320-7444",
            "fax_number": "570-320-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILPATRICK",
        "first_name": "NICHOLAS",
        "middle_name": "AARON",
        "credential": "PA-C, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061942",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidspeace National Centers Inc
• Valerie R Kieffer
• Lisa Marie Kieser, PA-C
• Cindy A Kiess, REGISTERED NURSE
• Matthew Roger Kiley, MD
• Dixie Kime
• Susan E King, LCSW
• Seth John Kinley, A.T.,C.
• Dana Kirschner
• Kevin William Kist Jr., DO

• Physician Assistant in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.