Active NPI
Anna Killeen, PA-C
- Physician Assistant
- Holland, MI
National Provider Identifier
1922283993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601004321
- Practice address
- 588 E Lakewood Blvd
2ND Floor
Holland, MI 49424-2023 - Phone
- (616) 494-5810
- Fax
- (616) 494-5901
- NPI assigned
- Jan 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601004321 | MI | Primary |
Addresses
Primary practice location
588 E Lakewood Blvd
2ND Floor
Holland, MI 49424-2023
Mailing address
100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6557
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922283993 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | annakilleen@uhps.allscriptsdirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Wayne State University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11100 Euclid Ave
Cleveland, OH 44106-1716
3909 Orange PL
Suite 1100
Beachwood, OH 44122-4480
Phone (216) 896-1755
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.19 of 100
- Quality
- 63.13
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.18
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Hospitals Medical Group Inc | Current | Accepting new patients | |
| Multicare Health System | Physician Assistant | Past | Accepting new patients |
Locations
8055 Mayfield Rd
Ste 105
Chesterland, OH 44026
Phone (440) 214-8024
11100 Euclid Ave
Cleveland Heights, OH 44106
Interoperability endpoints
- akilleen27945@ehrdirect.uhhospitals.org
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Cleveland, OH
- NPI 1669499414
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1043397292
-
- Multi-Specialty Clinic/Center
- Mentor, OH
- NPI 1487770335
Hospital
-
- Multi-Specialty Clinic/Center
- Westlake, OH
- NPI 1669598082
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1922283993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-486-6557",
"fax_number": "616-486-6702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "588 E LAKEWOOD BLVD",
"address_2": "2ND FLOOR",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494242023",
"telephone_number": "616-494-5810",
"fax_number": "616-494-5901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLEEN",
"first_name": "ANNA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-08",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601004321",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922283993",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "annakilleen@uhps.allscriptsdirect.net",
"affiliation": "N",
"address_1": "11100 Euclid Ave",
"city": "Cleveland",
"state": "OH",
"country_code": "US",
"postal_code": "441061716",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.