Kelly Marie Reynolds, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA058352 Issued in PA

Practice address

1 Guthrie SQ
Sayre, PA 18840-1625

Phone

(570) 887-2855

Fax

(570) 887-2033

NPI assigned

Jan 22, 2013

Last updated

Aug 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Season Dermatology PLLCGroup PAC ID 3577820851, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.88 of 100Reported as group

Quality

97.2

Improvement activities

40

Cost

100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Season Dermatology, PLLC

  dba Anew Dermatology

  • MOHS-Micrographic Surgery Physician
  • Johnson City, NY
  • NPI 1992215180
  Medicare reassignment Care Compare group
• United Health Services Hospitals, Inc.

  • Multi-Specialty Clinic/Center
  • Johnson City, NY
  • NPI 1962463851
  Medicare reassignment NPD
• United Medical Associates PC

  • Clinic/Center
  • Binghamton, NY
  • NPI 1013972801
  Medicare reassignment NPD
• Guthrie Medical Group, P.C.

  • Family Medicine Physician
  • Athens, PA
  • NPI 1962451153
  Medicare reassignment
• Exigence Medical of Binghamton PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Binghamton, NY
  • NPI 1659464758
  Medicare reassignment
• Guthrie Clinic, LTD

  • Plastic Surgery Physician
  • Sayre, PA
  • NPI 1588616932
  NPD
• Guthrie Medical Group, P.C.

  • General Practice Physician
  • Sayre, PA
  • NPI 1245246644
  NPD

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1730427071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-887-2855",
            "fax_number": "570-887-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016285",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Reed
• Russell Eugene Rees, M.D.
• Felice Lynn Reitknecht, M.D.
• Renegade Performance LLC
• Renegade Performance LLC
• Julie Lynn Richards, DNP
• Kim L Rickert, MD
• Jennifer Leigh Riley, RN, CDE
• Francisco L. Rilloraza, M.D.
• Steven Rinehouse, MD

• Physician Assistant in Sayre, PA
• Providers in Sayre, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.