Kristen L Cavanaugh, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

OA003255 Issued in PA

Practice address

4300 Londonderry Rd
Harrisburg, PA 17109-5317

Phone

(717) 988-0000

Fax

(717) 782-5716

NPI assigned

Mar 17, 2014

Last updated

Jan 16, 2021By 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 1

Addresses

Other identifiers 1

Other names 1

• Kristen L McMullan Former name

Electronic endpoints 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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

93.46 of 100Reported as group

Quality

92.17

Promoting interoperability

100

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: kcavanaugh283780@upmc.direct-ci.com

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.

• Pinnacle Health Emergency Department Services LLC

  • Emergency Medicine Physician
  • Harrisburg, PA
  • NPI 1487693404
  Medicare reassignment
• Camp Hill Emergency Physicians LLC

  • Emergency Medicine Physician
  • Camp Hill, PA
  • NPI 1720037997

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610755200000",
    "number": "1851717615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-988-0000",
            "fax_number": "717-782-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONDONDERRY RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095317",
            "telephone_number": "717-988-0000",
            "fax_number": "717-782-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2021-01-16",
        "certification_date": "2021-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA003255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103190636",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcavanaugh52744@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "4300 Londonderry Rd",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171095317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "MCMULLAN",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Catholic Charities of the Diocese of Harrisburg PA Inc
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• CCN America LP (Coordinated Care Network Pharmacy)
• CD East Family Health & Wellness Center LLC (CD East Family Health & Wellness Center)
• CDG Harrisburg LLC (Colonial Dental Group)
• CDH Orthodontics, LLC
• CDS Group LLC (STR Behavioral Health - Harrisburg)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2021; 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.