Kyle Fetterolf, PA - Medicare Physician Assistant in Kingston, PA

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Kyle Fetterolf, PA is a medicare enrolled "Physician Assistant" in Kingston, Pennsylvania. He graduated from nursing school in 1999 and has 27 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Commonwealth Physician Network Llc and his current practice location is 423 3rd Ave Ste B, Kingston, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (570) 288-3601.

Kyle Fetterolf is licensed to practice in Pennsylvania (license number MA001889L) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1477529501.

Contact Information

Kyle Fetterolf, PA
423 3rd Ave Ste B,
Kingston, PA 18704-5809
(570) 288-3601
(570) 288-1726

Map and Direction




Provider's Profile

Full NameKyle Fetterolf
GenderMale
SpecialityPhysician Assistant
Experience27 Years
Location423 3rd Ave Ste B, Kingston, Pennsylvania
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kyle Fetterolf graduated from nursing school in 1999
  NPI Data:
  • NPI Number: 1477529501
  • Provider Enumeration Date: 02/28/2006
  • Last Update Date: 02/13/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 2163423195
  • Enrollment ID: I20070118000165

Medical Identifiers

Medical identifiers for Kyle Fetterolf such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477529501NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant MA001889L (Pennsylvania)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Wilkes-barre General HospitalWilkes-barre, PAHospital
Regional Hospital Of ScrantonScranton, PAHospital
Lehigh Valley Hospital - HazletonHazleton, PAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Commonwealth Physician Network Llc266869659263

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. Kyle Fetterolf allows following entities to bill medicare on his behalf.
Entity NameAtlantic Physician Services of Maryland, PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730129594
PECOS PAC ID: 5193619765
Enrollment ID: O20040504000401
Entity NameEmergency Care Services of Pennsylvania PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114955010
PECOS PAC ID: 1759301799
Enrollment ID: O20051206000046
Entity NameMedexpress Urgent Care, PC - Pennsylvania
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982839031
PECOS PAC ID: 8224181482
Enrollment ID: O20090805000511
Entity NamePennsylvania Physician Services, LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497059802
PECOS PAC ID: 1153507025
Enrollment ID: O20110511000343
Entity NameCommonwealth Physician Network LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003238635
PECOS PAC ID: 2668696592
Enrollment ID: O20140617000549

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. Kyle Fetterolf 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 AddressPractice Location Address
Kyle Fetterolf, PA
423 3rd Ave Ste B,
Kingston, PA 18704-5809

Ph: (570) 288-3601		Kyle Fetterolf, PA
423 3rd Ave Ste B,
Kingston, PA 18704-5809

Ph: (570) 288-3601

Reviews and Comments


Physician Assistant Nurses in Kingston, PA

Miss Jessica R Eberle, PA-C
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Medicare: Accepting Medicare Assignments
Practice Location: 560 Pierce St, Kingston, PA 18704
Phone: 570-714-5810    Fax: 570-714-5811
Sara Mccormack, PA-C
Physician Assistant
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Practice Location: 560 Pierce St, Kingston, PA 18704
Phone: 570-283-2161    
Ms. Nicole Sklareski, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 560 Pierce St, Kingston, PA 18704
Phone: 570-714-5810    Fax: 570-714-5811
Mia Charmian Gruler, PA-C
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Medicare: Not Enrolled in Medicare
Practice Location: 390 Pierce St, Kingston, PA 18704
Phone: 570-288-3535    
Giles Lobb, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 560 Pierce St, Kingston, PA 18704
Phone: 570-714-5810    Fax: 570-714-5811
Mary Kathleen Kirchner,
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Medicare: Accepting Medicare Assignments
Practice Location: 610 Wyoming Ave, Kingston, PA 18704
Phone: 570-288-5441    
Alysha Davis, PA-C
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Medicare: Accepting Medicare Assignments
Practice Location: 445 Wyoming Ave, Kingston, PA 18704
Phone: 570-718-0520    Fax: 570-718-0522

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.