Kristine Kelley, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD032146E Issued in PA

Practice address

225 Penn Ave
Scranton, PA 18503-1921

Phone

(570) 342-7864

Fax

(570) 342-7119

NPI assigned

Jan 30, 2006

Last updated

Jan 20, 2022By 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

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Delta Medix PC

  • Legal Medicine
  • Scranton, PA
  • NPI 1396701876
  Medicare reassignment NPD
• Pathology Associates of NE PA LTD

  • Anatomic Pathology & Clinical Pathology Physician
  • Dunmore, PA
  • NPI 1528022142
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1811968621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PENN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031921",
            "telephone_number": "570-342-7864",
            "fax_number": "570-342-7119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Lackawanna Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185032001",
            "country_code": "US",
            "telephone_number": "570-342-7864",
            "fax_number": "570-840-2987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "PA",
            "license": "MD-032146-E",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD032146E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011243520001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Andrew Kearney, MS, CAADC, LPC
• Jennifer Louise Kearney, DPT
• Suzanne Kearney
• Emily Keeler, D.O.
• William H Kehrli, MD
• Alexis Catherine Kelly, MSW, LCSW
• Carena Kelly, PA-C
• Catherine Kelly
• Eileen Kelly, LSW
• Jeffrey Kelly

• Surgery Physician in Scranton, PA
• Providers in Scranton, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.