Kelly Richards, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

963 Town Center Dr
Suite 100
Orange City, FL 32763-8254

Phone

(386) 774-9880

Fax

(386) 774-2898

NPI assigned

Aug 9, 2013

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 2

Medicare fee-for-service enrollment

Enrolled in FL, PA2 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 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle ENT Alliance LLCGroup PAC ID 7416963988, 70 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.53 of 100Reported as group

Quality

74.41

Promoting interoperability

65

Improvement activities

40

Cost

86.51

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: richards.kelly.009.0090158@aent.meditab.direct-ci.com
• Direct secure messaging: richards.kelly.008.0090158@aent.meditab.direct-ci.com
• Direct secure messaging: richards.kelly.007.0090158@aent.meditab.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 and National Provider Directory roles.

• Pinnacle ENT Alliance LLC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Wayne, PA
  • NPI 1538230313
  Medicare reassignment Care Compare group
• Atlantic Ear Nose & Throat PA

  • Otolaryngology Physician
  • Orange City, FL
  • NPI 1710932405
  Medicare reassignment

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1861825127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 TOWN CENTER DR",
            "address_2": "SUITE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638254",
            "telephone_number": "386-774-9880",
            "fax_number": "386-774-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 TOWN CENTER DR",
            "address_2": "SUITE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638254",
            "telephone_number": "386-774-9880",
            "fax_number": "386-774-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "02004368",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OO9981300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan I. Rey Robles, FNP-C
• Maricelys Reyes
• Randy P Rhames
• Tamica D Rhodes, CNM
• Ana I Ribeiro, ARNP
• Christian Richardson, APRN
• Carline Rickman
• Amber Rieves
• Sarah Rintz, OTR
• Marimar Rios Santiago, DPT

• Physician Assistant in Orange City, FL
• Providers in Orange City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.