Kaitlyn Susanna Kelley, CRNP is a medicare enrolled "Nurse Practitioner - Family" physician in Philadelphia, Pennsylvania. Her current practice location is
2601 Holme Ave, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(215) 335-7705.
Kaitlyn Susanna Kelley is licensed to practice in Pennsylvania (license number SP025112) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215661673.
Physician's Profile
Full Name | Kaitlyn Susanna Kelley |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 2601 Holme Ave, Philadelphia, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1215661673
- Provider Enumeration Date: 07/12/2022
- Last Update Date: 01/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 3779965231
- Enrollment ID: I20220729002034
Medical Identifiers
Medical identifiers for Kaitlyn Susanna Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215661673 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | SP025112 (Pennsylvania) | Secondary |
363LF0000X | Nurse Practitioner - Family | SP025112 (Pennsylvania) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kaitlyn Susanna Kelley allows following entities to bill medicare on her behalf.
Entity Name | Nazareth Physician Services, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1285150458 PECOS PAC ID: 0941229017 Enrollment ID: O20171026001610 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kaitlyn Susanna Kelley is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kaitlyn Susanna Kelley, CRNP 2601 Holme Ave, Philadelphia, PA 19152-2007 Ph: (215) 335-7705 | Kaitlyn Susanna Kelley, CRNP 2601 Holme Ave, Philadelphia, PA 19152-2007 Ph: (215) 335-7705 |
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