Kelsey Lange Pierce, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

055.0031242 Issued in VT

Practice address

140 Hospital Dr
Suite 111
Bennington, VT 05201-5009

Phone

(802) 440-4077

NPI assigned

Apr 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Specialty

Physician Assistant

Education

Tufts University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwestern Vermont Medical Center, IncGroup PAC ID 0143138446, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwestern Vermont Medical Center Hospital, Bennington, VT, CCN 470012

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 and National Provider Directory roles.

• Southwestern Vermont Medical Center Inc.

  • General Acute Care Hospital
  • Bennington, VT
  • NPI 1205865789
  Medicare reassignment Care Compare group NPD
• Southwestern Vermont Medical Center Inc.

  • Internal Medicine Physician
  • Bennington, VT
  • NPI 1184994162
  Medicare reassignment NPD (past)

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

• Southwestern Vermont Medical Center Inc.

  • General Acute Care Hospital
  • Bennington, VT
  • NPI 1205865789
  Care Compare affiliation

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1740675065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HOSPITAL DR",
            "address_2": "SUITE 111",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HOSPITAL DR",
            "address_2": "SUITE 111",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015009",
            "telephone_number": "802-440-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "KELSEY",
        "middle_name": "LANGE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M Pezzulich, PSY.D.
• Robert Anthony Pezzulich, MD
• Pharmacy Inc
• Pharmacy Inc
• Joseph M. Phillips, RT(N), CNMT
• Susan Lee Pierce, LICSW
• Lawrence Joseph Pietrucha, D.D.S.
• Katherine Tapp Piispanen, OTR
• Larissa Pitrat
• Planned Parenthood of Northern New England

• Physician Assistant in Bennington, VT
• Providers in Bennington, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.