Individual provider Active NPI

Kelley E Burger, PA-C

  • Physician Assistant
  • State College, PA
National Provider Identifier
1700190444
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA002967 Issued in PA
Practice address
200 Scenery Dr
State College, PA 16801-7974
Phone
(814) 231-4560
NPI assigned
Aug 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA054419 PA
Physician Assistant 363A00000X OA002967 PA Primary

Addresses

Primary practice location

200 Scenery Dr
State College, PA 16801-7974

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kburger96896@direct.geisinger.edu Direct

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
I20101130001169 PA Practitioner - Physician Assistant 2365638566 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OA002967PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC CurrentSince Mar 22, 2021 Accepting new patients
Geisinger-HM Joint Venture, LLC Physician Assistant CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic Physician Assistant CurrentSince Dec 1, 2011 Accepting new patients
Geisinger Clinic Physician Assistant Current Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

819 E Bishop St
Bellefonte, PA 16823
Phone (814) 353-3501

226 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

174 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

224 N Logan Blvd
Burnham, PA 17009
Phone (717) 242-0196

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

175 Northumberland St
Danville, PA 17821
Phone (570) 284-4575

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

68 Spring St
Lock Haven, PA 17745
Phone (570) 263-5830

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

210 Medical Center Dr
Philipsburg, PA 16866
Phone (814) 342-8001

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

1630 N Atherton St
State College, PA 16803
Phone (814) 238-1279

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

Interoperability endpoints

  • Direct secure messaging: kburger96896@direct.geisinger.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1700190444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SCENERY DR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017974",
            "telephone_number": "814-231-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGER",
        "first_name": "KELLEY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-05",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054419",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA002967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kburger96896@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 Scenery Dr",
            "city": "State College",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168017974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.