NPIMap

Individual provider Active NPI

Kelly Nicole Evans, PA

  • Surgical Physician Assistant
  • Allentown, PA
National Provider Identifier
1851628002
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA057361 Issued in PA
Practice address
250 Cetronia Rd
Allentown, PA 18104-9147
Phone
(610) 973-6200
Fax
(866) 644-0894
NPI assigned
Nov 9, 2009
Last updated
Feb 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA057361 PA Primary

Addresses

Primary practice location

250 Cetronia Rd
Allentown, PA 18104-9147

Mailing address

250 Cetronia Rd
Suite 303
Allentown, PA 18104-9147
Phone (610) 973-6200

Other names 1

  • Kelly Nicole Lea Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150228000152 PA Practitioner - Physician Assistant 8921148859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

250 Cetronia Rd
Suite 303
Allentown, PA 18104-9168
Phone (610) 973-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.37 of 100Reported as group
Quality
72.6
Promoting interoperability
100
Improvement activities
40
Cost
78.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA057361PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Allentown CurrentSince Feb 9, 2015 Accepting new patients
Orthopaedic Associates of Allentown Past Accepting new patients

Locations

250 Cetronia Rd
Ste 303
Allentown, PA 18104

1241 Blakeslee Boulevard Dr E
Lehighton, PA 18235
Phone (570) 386-6900

Organizations & group practices 2

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1851628002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CETRONIA RD",
            "address_2": "SUITE 303",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049147",
            "telephone_number": "610-973-6200",
            "fax_number": "866-644-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CETRONIA RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181049147",
            "telephone_number": "610-973-6200",
            "fax_number": "866-644-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-09",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA057361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "LEA",
            "middle_name": "NICOLE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.