Individual provider Active NPI

Kelly R Leite, D.O.

  • Pediatrics Physician
  • Hershey, PA
National Provider Identifier
1700836244
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS009022L Issued in PA
Practice address
35 Hope Dr
Suite 102
Hershey, PA 17033-2086
Phone
(717) 531-7300
Fax
(717) 531-3527
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS009022L PA Primary

Addresses

Primary practice location

35 Hope Dr
Suite 102
Hershey, PA 17033-2086

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other practice location 1

2645 N 3rd St Fl 2
Harrisburg, PA 17110-2001
Phone (717) 782-4650

Other identifiers 1

IdentifierTypeStateIssuer
0015194250010MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kleite6913@phsdirect.pinnaclehealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000272 PA Practitioner - Pediatric Medicine 7911963111 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Pediatrics Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Jan 11, 2016 Accepting new patients
Pinnacle Health Medical Services CurrentSince Jan 11, 2016 Accepting new patients

Locations

2645 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-4650

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2645 N 3rd St
Harrisburg, PA 17110
Phone (717) 782-4650

Organizations & group practices 3

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1700836244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HOPE DR",
            "address_2": "SUITE 102",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332086",
            "telephone_number": "717-531-7300",
            "fax_number": "717-531-3527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2645 N 3rd St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171102001",
            "country_code": "US",
            "telephone_number": "717-782-4650",
            "fax_number": "717-782-4665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEITE",
        "first_name": "KELLY",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS009022L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015194250010",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kleite6913@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2645 N 3rd St Fl 2",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171102001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.