Kelli Ann Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

OA006130 Issued in PA

Practice address

30 Hope Dr
Hershey, PA 17033-2036

Phone

(717) 531-3828

Fax

(717) 531-4694

NPI assigned

Jul 27, 2022

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 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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
• Penn State Health Lancaster Medical Center Hospital, Lancaster, PA, CCN 390339
• Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096
• Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

Merit-based Incentive Payment System (MIPS)

Final score

79.36 of 100Reported as group

Quality

56.69

Promoting interoperability

100

Improvement activities

40

Cost

74.52

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.

• The Milton S Hershey Medical Center Physicians Group

  • Orthopaedic Surgery Physician
  • Hershey, PA
  • NPI 1710951744
  Medicare reassignment Care Compare group
• The Milton S Hershey Medical Center Physician Group

  • Body Imaging Physician
  • Hershey, PA
  • NPI 1346215928
  NPD
• The Milton S Hershey Medical Center Physician Group

  • Neurology Physician
  • Hershey, PA
  • NPI 1629043203
  NPD
• The Milton S. Hershey Medical Center Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Hershey, PA
  • NPI 1255482089
  NPD (past)

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

• Lancaster General Hospital

  • General Acute Care Hospital
  • Lancaster, PA
  • NPI 1104875103
  Care Compare affiliation
• Lancaster General Hospital

  • General Acute Care Hospital
  • Parkesburg, PA
  • NPI 1245571942
  Care Compare affiliation
• Lancaster General Hospital

  • Ambulatory Surgical Clinic/Center
  • Lancaster, PA
  • NPI 1538290424

  Hospital

  Care Compare affiliation
• Penn State Health Lancaster Medical Center

  • General Acute Care Hospital
  • Lancaster, PA
  • NPI 1013674266
  Care Compare affiliation
• St Joseph Regional Health Network

  • General Acute Care Hospital
  • Reading, PA
  • NPI 1699734665
  Care Compare affiliation
• The Milton S Hershey Medical Center

  • General Acute Care Hospital
  • Hershey, PA
  • NPI 1568435477
  Care Compare affiliation

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1760118228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 HEMLOCK CT",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170333204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HOPE DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332036",
            "telephone_number": "717-531-3828",
            "fax_number": "717-531-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA006130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie Clark, CRNP
• Ashley Clark, PA-C
• Breanna Clark, CRNP
• Cassra B Clark, MD, MS
• Joseph Y. Clark, M.D.
• Kristen Clark, AUD
• Matthew Clark, DO
• Pamela A. Clark, MD
• Roderick Clark, MD
• Emily Clarke

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.