Andrea Maluta Kelly, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001004126 Issued in NC

Practice address

2015 Randolph Rd Ste 208
Charlotte, NC 28207-1241

Phone

(704) 377-4009

NPI assigned

Sep 15, 2011

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 identifiers 2

Other names 1

• Andrea Maluta Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charlotte Gastroenterology and Hepatology PLLCGroup PAC ID 3870489412, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

Merit-based Incentive Payment System (MIPS)

Final score

95.22 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

84.08

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 and National Provider Directory roles.

• Charlotte Gastroenterology & Hepatology, PLLC

  • Gastroenterology Physician
  • Huntersville, NC
  • NPI 1730100801
  Medicare reassignment Care Compare group NPD
• Carolina Digestive Health Associates, PA

  • Gastroenterology Physician
  • Charlotte, NC
  • NPI 1124052444
  Medicare reassignment NPD
• Charlotte Gastroenterology & Hepatology, PLLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1851548655
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• The Presbyterian Hospital

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation
• The Presbyterian Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1689956641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13808 PROFESSIONAL CENTER DR STE 302",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787948",
            "telephone_number": "704-377-4009",
            "fax_number": "704-602-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 RANDOLPH RD STE 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071241",
            "telephone_number": "704-377-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANDREA",
        "middle_name": "MALUTA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001004126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2531PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689956641",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Charlotte",
            "affiliation": "N",
            "address_1": "2015 Randolph Rd Ste 208",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MALUTA",
            "credential": "P.A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Blake Jillian Kellum, LCMHC
• Kelly Saylor Counseling & Consulting Services, PLLC
• Alyse Margaret Kelly-Jones, MD
• Allie Black Kelly, P.A.C
• Amy Henderson Kelly, NP
• Ashley Denise Kelly, PHARMD
• Aubrey Kelly
• Barbara Sorrels Kelly, CRNA
• Daniel L Kelly, MD
• Daniel Rory Kelly, MD

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.