Individual provider Active NPI

Kelley Crane

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1972992824
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4940 Eastern Ave Ste a-150
Baltimore, MD 21224-2735
Phone
(410) 550-0360
Fax
(410) 550-0178
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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 PA9109649 FL
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

4940 Eastern Ave Ste a-150
Baltimore, MD 21224-2735

Mailing address

4940 Eastern Ave Ste a-150
Baltimore, MD 21224-2735
Phone (410) 550-0360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161104000648 FL Practitioner - Physician Assistant 0042538845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.84 of 100Reported as group
Quality
86.07
Improvement activities
40
Cost
75.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9109649FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

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.

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1972992824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE STE A-150",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0360",
            "fax_number": "410-550-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 EASTERN AVE STE A-150",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242735",
            "telephone_number": "410-550-0360",
            "fax_number": "410-550-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "KELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109649",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.