Individual provider Active NPI

Kelly A Valasek, PA-C

  • Medical Physician Assistant
  • Butler, PA
National Provider Identifier
1730368465
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA055087 Issued in PA
Practice address
102 Technology Dr Ste 230
Butler, PA 16001-1784
Phone
(877) 661-3376
Fax
(724) 482-2212
NPI assigned
Oct 30, 2007
Last updated
Apr 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA055087 PA Primary

Addresses

Primary practice location

102 Technology Dr Ste 230
Butler, PA 16001-1784

Mailing address

PO Box 1549
Butler, PA 16003-1549
Phone (724) 284-4060

Other identifiers 2

IdentifierTypeStateIssuer
1032288870001MedicaidPA
CAQHOtherPA12295748

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
I20111108000688 PA Practitioner - Physician Assistant 7214017961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Butler Medical ProvidersGroup PAC ID 7416840160, 355 clinicians

Practice addresses (Care Compare)

102 Technology Dr
Butler, PA 16001-1784

127 Oneida Valley Rd
Suite 400
Butler, PA 16001-2251
Phone (833) 995-0118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA055087PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Butler Medical Providers CurrentSince May 1, 2018 Accepting new patients
Butler Medical Providers CurrentSince May 1, 2018 Accepting new patients
Butler Medical Providers Past Accepting new patients
Butler Medical Providers Past Accepting new patients

Locations

102 Technology Dr
Ste 230
Butler, PA 16001
Phone (724) 283-0076

127 Oneida Valley Rd
Ste 400
Butler, PA 16001
Phone (724) 431-0550

24 Doctors Ln
Ste 201
Clarion, PA 16214
Phone (833) 684-1898

300 Northpointe Cir
Ste 104
Seven Fields, PA 16046
Phone (833) 391-0738

Organizations & group practices 5

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 3

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": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1730368465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1549",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160031549",
            "telephone_number": "724-284-4060",
            "fax_number": "724-284-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 TECHNOLOGY DR STE 230",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011784",
            "telephone_number": "877-661-3376",
            "fax_number": "724-482-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALASEK",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-30",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032288870001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "12295748",
            "identifier": "CAQH",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.