Kelly Kathleen Faillo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

500 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017-3454

Phone

(859) 341-4842

NPI assigned

Aug 24, 2010

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 KY, IN, OH3 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 3

Specialty

Physician Assistant

Education

Saint Louis University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Radiology Associates of Northern Kentucky PLLCGroup PAC ID 3779480736, 56 clinicians

Tri State Urologic Services PSC IncGroup PAC ID 6204740889, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
• St Elizabeth Florence Hospital, Florence, KY, CCN 180045
• St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001
• St Elizabeth Dearborn Hospital Hospital, Lawrenceburg, IN, CCN 150086
• Carroll County Memorial Hospital Hospital, Carrollton, KY, CCN 181310

Merit-based Incentive Payment System (MIPS)

Final score

93.01 of 100Reported as apm

Quality

86.02

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.83 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Cost

83.09

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.

• Radiology Associates of Northern Kentucky, PLLC

  • Diagnostic Radiology Physician
  • Edgewood, KY
  • NPI 1073595179

  IN

  Medicare reassignment Care Compare group
• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
  • NPI 1396938312
  Medicare reassignment Care Compare group
• Gcga Physicians Inc.

  • Gastroenterology Physician
  • Cincinnati, OH
  • NPI 1790851095
  Medicare reassignment
• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Fairfield, OH
  • NPI 1073746459
  NPD
• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
  • NPI 1912729005
  NPD
• Lester S Duplechan MD PLLC

  • Physical Medicine & Rehabilitation Physician
  • Crestview Hills, KY
  • NPI 1801113071
  NPD (past)
• St Elizabeth Medical Center, Inc

  • Community/Retail Pharmacy
  • Florence, KY
  • NPI 1104699453
  NPD (past)
• Tri State Urologic Services PSC Inc

  • Urology Physician
  • Cincinnati, OH
  • NPI 1568404846
  NPD (past)

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

• CCMH Corporation

  • Critical Access Hospital
  • Carrollton, KY
  • NPI 1225159601
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Florence, KY
  • NPI 1154365062
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Fort Thomas, KY
  • NPI 1740221795
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Lawrenceburg, IN
  • NPI 1326142498
  Care Compare affiliation

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1760798052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 THOMAS MORE PKWY",
            "address_2": "STE 200",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173454",
            "telephone_number": "859-341-4842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 THOMAS MORE PKWY",
            "address_2": "STE 200",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173454",
            "telephone_number": "859-341-4842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILLO",
        "first_name": "KELLY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105470",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Ernst-Pierson, MD
• Matt John Ernst, PT, OCS
• Chelsea Marie Esmeier, PSYD
• Brooke N Evans
• Daniel G Fagel, M.D.
• James Farrell, M.D.
• Luke Farrell, ATC
• Justin William Florek, D.C.
• Amy Jo Florence, LCSW
• Jamie L Flynn, PT

• Physician Assistant in Crestview Hills, KY
• Providers in Crestview Hills, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.