NPIMap

Individual provider Active NPI

Kylie Allissa McClain, PA-C

  • Medical Physician Assistant
  • Du Bois, PA
National Provider Identifier
1881281723
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA062018 Issued in PA
Practice address
123 Hospital Ave
Du Bois, PA 15801-1409
Phone
(814) 371-1900
Fax
(814) 503-8568
NPI assigned
Dec 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X MA062018 PA Primary

Addresses

Primary practice location

123 Hospital Ave
Du Bois, PA 15801-1409

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440

Other practice location 1

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 371-2200

Other practice location 2

265 Holiday Inn Rd
Clarion, PA 16214-4034
Phone (814) 371-1900

Other identifiers 1

IdentifierTypeStateIssuer
103894366MedicaidPA

Other names 1

  • Kylie Alissa Hannold 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
I20210521000275 PA Practitioner - Physician Assistant 9032518105 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians

Practice addresses (Care Compare)

100 Meadow LN
Suite 4
Du Bois, PA 15801-2460
Phone (814) 375-0600

265 Holiday Inn Rd
Clarion, PA 16214-4034

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brookville Hospital Physician Assistant CurrentSince Apr 26, 2021 Accepting new patients
Dubois Regional Medical Center CurrentSince Apr 21, 2021 Accepting new patients
Brookville Hospital Physician Assistant CurrentSince Apr 26, 2021 Accepting new patients
Dubois Regional Medical Center Physician Assistant CurrentSince Apr 21, 2021 Accepting new patients
Dubois Regional Medical Center CurrentSince Sep 5, 2022 Accepting new patients

Locations

100 Hospital Rd
Brookville, PA 15825
Phone (814) 849-1408

265 Holiday Inn Rd
Clarion, PA 16214
Phone (814) 297-8848

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

123 Hospital Ave
Dubois, PA 15801
Phone (814) 371-1510

Interoperability endpoints

  • Direct secure messaging: kylie.mcclain.1@6640.direct.athenahealth.com

Organizations & group practices 6

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1609027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1881281723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011409",
            "telephone_number": "814-371-1900",
            "fax_number": "814-503-8568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Du Bois",
            "state": "PA",
            "postal_code": "158011440",
            "country_code": "US",
            "telephone_number": "814-371-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 Holiday Inn Rd",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "162144034",
            "country_code": "US",
            "telephone_number": "814-371-1900",
            "fax_number": "814-503-8568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "KYLIE",
        "middle_name": "ALLISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-27",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA062018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103894366",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "HANNOLD",
            "middle_name": "ALISSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.