Individual provider Active NPI

Kelly A. M. Martin, MSN, CRNP-BC

  • Acute Care Nurse Practitioner
  • Hershey, PA
National Provider Identifier
1922437565
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP012659 Issued in PA
Practice address
30 Hope Dr
Hershey, PA 17033-2036
Phone
(717) 531-0003
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP012659 PA Primary

Addresses

Primary practice location

30 Hope Dr
Hershey, PA 17033-2036

Mailing address

30 Hope Dr
PO Box 859
Hershey, PA 17033-2036
Phone (717) 531-0003

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
I20140110000145 PA Practitioner - Nurse Practitioner 7113155524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Hope Dr
Suite 2400
Hershey, PA 17033-2036
Phone (717) 531-5638

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP012659PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Dec 2, 2013 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Dec 2, 2013 Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

30 Hope Dr
Ste 2400
Hershey, PA 17033
Phone (717) 531-5638

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

30 Hope Dr
Hershey, PA 17033
Phone (717) 531-3828

3100 Schoolhouse Rd
Middletown, PA 17057
Phone (717) 948-5180

Organizations & group practices 3

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 5

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": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1922437565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HOPE DR",
            "address_2": "PO BOX 859",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332036",
            "telephone_number": "717-531-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HOPE DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332036",
            "telephone_number": "717-531-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KELLY",
        "middle_name": "A. M.",
        "name_prefix": "Mrs.",
        "credential": "MSN, CRNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP012659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.