COLLEEN KELLY P.A.
NPI 1972755205
Physician Assistant - Surgical in Commack, NY

NPI Status: Active since October 17, 2008

Contact Information

763 LARKFIELD RD FL 2
COMMACK, NY
ZIP 11725
Phone: (631) 462-2225
Fax: (631) 670-2643

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  • Individual
  • Female
  • Years of Experience 22
  • Physician Assistant
  • Surgical
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About COLLEEN KELLY

This page provides the complete NPI Profile along with additional information for Colleen Kelly, a provider established in Commack, New York with a medical specialization in Physician Assistant, focusing in surgical and more than 22 years of experience. The healthcare provider is registered in the NPI registry with number 1972755205 assigned on October 2008. The practitioner's primary taxonomy code is 363AS0400X with license number 010544 (AZ). The provider is registered as an individual and her NPI record was last updated 17 years ago.

NPI
1972755205
Provider Name
COLLEEN KELLY P.A.
Gender
Female
Entity Type
Individual
Location Address
763 LARKFIELD RD FL 2 COMMACK, NY 11725
Location Phone
(631) 462-2225
Location Fax
(631) 670-2643
Mailing Address
763 LARKFIELD RD FL 2 COMMACK, NY 11725
Mailing Phone
(631) 462-2225
Mailing Fax
(631) 670-2643
Medical School Name
OTHER
Graduation Year
2004
Is Sole Proprietor?
No
Enumeration Date
10-17-2008
Last Update Date
10-17-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Surgical

Taxonomy Code
363AS0400X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
010544
License State
AZ

Medicare Participation & PECOS Enrollment Status

Colleen Kelly is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Colleen Kelly is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4284797077

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20090105000438

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 19 times for 18 patients

Reviews for COLLEEN KELLY P.A.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1972755205
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
291421451020
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 4 + 2 + 1 + 4 + 5 + 1 + 0 + 2 + 0 + 24 = 55
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 55 = 55

The NPI number 1972755205 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1851450977 ROBERT ANTHONY RISELVATO PA
Individual
Physician Assistant (Surgical)763 LARKFIELD RD FL 2
COMMACK, NY 11725
(631) 462-2225
1982608592 NEAL H FRAUWIRTH MD
Individual
Pain Medicine (Pain Medicine)763 LARKFIELD RD FL 2
COMMACK, NY 11725
(631) 462-2225
1265964910 THOMAS JOSEPH DOWLING III
Individual
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)763 LARKFIELD RD FL 2
COMMACK, NY 11725
(631) 462-2225
1801133160 MOHAMMED WEISS SANZAR PA-C
Individual
Physician Assistant763 LARKFIELD RD FL 2
COMMACK, NY 11725
(631) 462-2225

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972755205, enumerated in the NPI registry as an "individual" on October 17, 2008

The provider is located at 763 Larkfield Rd Fl 2 Commack, Ny 11725 and the phone number is (631) 462-2225

The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical

The provider has more than 22 years of experience.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes.

This NPI record was last updated on October 17, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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