Kylie Plummer, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA053853 Issued in PA

Practice address

2525 9TH Ave
Suite 2a
Altoona, PA 16602-2014

Phone

(814) 943-7546

Fax

(814) 943-7543

NPI assigned

Nov 10, 2009

Last updated

Feb 25, 2025By the provider in NPPES

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

Other names 1

• Kylie Wallace Former name

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

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.

• Keystone Dermatology & Center for Skin Surgery, LLC

  • Dermatology Physician
  • Altoona, PA
  • NPI 1558549733
  Medicare reassignment
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1669709747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 9TH AVE",
            "address_2": "SUITE 2A",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022014",
            "telephone_number": "814-943-7546",
            "fax_number": "814-943-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 9TH AVE",
            "address_2": "SUITE 2A",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022014",
            "telephone_number": "814-943-7546",
            "fax_number": "814-943-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMMER",
        "first_name": "KYLIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "WALLACE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katrina Pipetti
• Heather Pisczek
• Pittsburgh Critical Care Associates, Inc
• Pleasant Valley Dental
• Jamie Plowman, NP
• Thomas Lee Plummer
• Paul Jason Pochak, PHARM.D
• Stephanie Podelco
• Ernest John Podrasky, LPC
• Amanda Polca, PA-C

• Medical Physician Assistant in Altoona, PA
• Providers in Altoona, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.