Individual provider Active NPI

Suzanne Carroll-Kelly, CRNP

  • Family Nurse Practitioner
  • East Stroudsburg, PA
National Provider Identifier
1720632524
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP020313 Issued in PA
Practice address
200 E Brown St
East Stroudsburg, PA 18301-3006
Phone
(570) 476-3700
Fax
(570) 476-3637
NPI assigned
Jul 30, 2019
Last updated
Oct 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP020313 PA Primary

Addresses

Primary practice location

200 E Brown St
East Stroudsburg, PA 18301-3006

Mailing address

2100 Mack Blvd FL 2
Allentown, PA 18103-5622
Phone (484) 884-4500

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
I20191210000034 PA Practitioner - Nurse Practitioner 4385077171 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

200 E Brown St
LVPG Family Medicine Esu
East Stroudsburg, PA 18301-3006
Phone (272) 762-4378

4541 Milford Rd
East Stroudsburg, PA 18302-9657
Phone (570) 395-2514

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.09 of 100Reported as group
Quality
74.47
Promoting interoperability
86
Improvement activities
40
Cost
74.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Schuylkill Health System Medical Group, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Family Care Centers Inc CurrentSince Oct 21, 2019 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Schuylkill Health System Medical Group, Inc. Family Current Accepting new patients
Family Care Centers Inc. Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

2100 Mack Blvd
Fl 2
Allentown, PA 18103

200 E Brown St
East Stroudsburg, PA 18301
Phone (570) 476-3700

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

500 Plaza Ct
Ste A
East Stroudsburg, PA 18301
Phone (570) 424-9970

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

200 Schuylkill Medical Plz
Pottsville, PA 17901
Phone (570) 621-9200

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1720632524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 2",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E BROWN ST",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-476-3700",
            "fax_number": "570-476-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL-KELLY",
        "first_name": "SUZANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP020313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.