Kelsey Marie Pellicone, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

020695 Issued in NY

Practice address

1978 Crompond Rd
Cortlandt Manor, NY 10567-4111

Phone

(914) 739-2121

NPI assigned

Mar 15, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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, 2017

Medicare assignment

May accept Medicare assignment

Group practices

State of New York Comptrollers OfficeGroup PAC ID 0840101770, 171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Helen Hayes Hospital Hospital, West Haverstraw, NY, CCN 330405
• Good Samaritan Hospital of Suffern Hospital, Suffern, NY, CCN 330158
• Westchester Medical Center Hospital, Valhalla, NY, CCN 330234
• Nyack Hospital Hospital, Nyack, NY, CCN 330104

Merit-based Incentive Payment System (MIPS)

Final score

86.46 of 100Reported as group

Quality

73.89

Promoting interoperability

89

Improvement activities

40

Cost

75.72

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.

• State of New York Comptrollers Office

  • Rehabilitation Hospital Unit
  • West Haverstraw, NY
  • NPI 1235142472
  Medicare reassignment Care Compare group
• Optum Medical Care, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• State of New York

  • Specialist
  • West Haverstraw, NY
  • NPI 1508987348
  NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD

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

• Good Samaritan Hospital of Suffern

  • General Acute Care Hospital
  • Suffern, NY
  • NPI 1346213469
  Care Compare affiliation
• Montefiore Nyack Hospital

  • General Acute Care Hospital
  • Nyack, NY
  • NPI 1104808062
  Care Compare affiliation
• State of New York Comptrollers Office

  • General Acute Care Hospital
  • West Haverstraw, NY
  • NPI 1063525442
  Care Compare affiliation
• Westchester County Health Care Corporation

  • General Acute Care Hospital
  • Valhalla, NY
  • NPI 1932280666
  Care Compare affiliation

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1760923353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1978 CROMPOND RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 CROMPOND RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105674111",
            "telephone_number": "914-739-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICONE",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "020695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04786994",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Lynette Paredes, LMHC
• Maureen Ilona Pasciuti, RDN
• Komila Pather
• Paul S Taxin, DMD, PC
• Elaine M Paulson
• Lindsey Goncalves Pereira
• Christopher Perez
• Donato Joseph Perretta, M.D.
• Paris Augustine Petridou, M.S. CCC-SLP
• Daniella Patricia Petrullo, PA

• Surgical Physician Assistant in Cortlandt Manor, NY
• Providers in Cortlandt Manor, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.