Individual provider Active NPI

Kelly E Little, PA-C

  • Physician Assistant
  • Princeton, NJ
National Provider Identifier
1871809772
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00243500 Issued in NJ
Practice address
325 Princeton Ave
Princeton, NJ 08540-1617
Phone
(609) 924-8131
Fax
(609) 924-8532
NPI assigned
Aug 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00243500 NJ Primary

Addresses

Primary practice location

325 Princeton Ave
Princeton, NJ 08540-1617

Mailing address

325 Princeton Ave
Princeton, NJ 08540-1617
Phone (609) 924-8131

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220808000009 PA Practitioner - Physician Assistant 7517156045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Health Mid-Atlantic Medical GroupGroup PAC ID 7416861885, 350 clinicians

Practice addresses (Care Compare)

1201 Langhorne Newtown Rd
Langhorne, PA 19047-1201

Hospital & facility affiliations

  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Aug 22, 2022 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Aug 22, 2022 Accepting new patients
Princeton Emergency Physicians, PA Past Accepting new patients
Trinity Health Mid-Atlantic Medical Group Past Accepting new patients
Trinity Health Mid-Atlantic Medical Group Past Accepting new patients

Locations

1203 Langhorne Newtown Rd
Ste 225
Langhorne, PA 19047
Phone (215) 710-4490

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1871809772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 PRINCETON AVE",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401617",
            "telephone_number": "609-924-8131",
            "fax_number": "609-924-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "KELLY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00243500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.