Alicia Peticolas Kelley, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

363A00000X Issued in MA

Practice address

15 Francis Street
PBB-B4
Boston, MA 02115

Phone

(617) 732-8003

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mass General Brigham Medical Group Suburban Massachusetts IncGroup PAC ID 0244133494, 534 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelley.alicia.nwh@direct.partners.masshiway.net

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.

• Mass General Brigham Medical Group Suburban Massachusetts Inc

  • Family Medicine Physician
  • Newton, MA
  • NPI 1538191218
  Medicare reassignment Care Compare group
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Lahey Clinic, Inc.

  • Internal Medicine Physician
  • Burlington, MA
  • NPI 1538194980
  Medicare reassignment
• Newton Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1952845521
  NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• Brigham Community Practices

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1295942159
  NPD (past)
• Inpatient Consultants of Massachusetts, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1093148926

  Medical

  NPD (past)

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

• Newton-Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1992737761
  Care Compare affiliation

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669545356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MAPLE CT",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017542342",
            "telephone_number": "978-897-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FRANCIS STREET",
            "address_2": "PBB-B4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ALICIA",
        "middle_name": "PETICOLAS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "363A00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geoffrey R Keller
• Jennifer Keller, PA-C
• Philip Raymond Keller
• Richard J Keller, MD
• Sarah Elizabeth Keller, RD
• Anthe Aliferis Kelley, DACCHM, REIKI MASTER
• Arlene Kelley, NP
• Ashley Barbara Kelley, ASHLEY KELLEY, MSPT
• Elizabeth Kelley
• James Kelley

• Medical Physician Assistant in Boston, MA
• Providers in Boston, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.