MRS. ALICIA PETICOLAS KELLEY (NPI# 1669545356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669545356 |
| Entity Type | Individual |
| Full Name | MRS. ALICIA PETICOLAS KELLEY |
| Credential | PA-C |
| Practice Address |
15 Francis Street Pbb-b4 Boston MA 02115 |
| Mailing Address |
3 Maple Ct Maynard MA 01754-2342 |
| Practice Telephone | 6177328003 |
| Mailing Telephone | 9788971536 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
363A00000X | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083890446 | Alicia A Kelley | Case Manager/Care Coordinator | 108 N First St, Oxford, AR 72565-9038 | 2008-01-16 |
| 1316565476 | Alicia Kelley | Acupuncturist | 80 E Rte 4 Ste 100, Paramus, NJ 07652-2647 | 2020-07-06 |
| 1093921124 | Alicia Roxanne Kelley | Counselor | 635 W College St, Florence, AL 35630-5313 | 2007-05-15 |
| Street Address |
15 FRANCIS STREET PBB-B4 |
| City | BOSTON |
| State | MA |
| Zip Code | 02115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528099215 | Anuj K Dalal | Internal Medicine | 15 Francis Street, Bwf Hospitalist Service, Pbb-b4-428, Boston, MA 02115 | 2006-07-05 |
| 1043666563 | Yijia Li | Student in an Organized Health Care Education/Training Program | 15 Francis Street, Pbb-a4, Boston, MA 02115 | 2016-05-13 |
| 1780048751 | Michelle Elizabeth Matzko | Student in an Organized Health Care Education/Training Program | 15 Francis Street, Pbb-a4, Boston, MA 02115-6105 | 2016-04-06 |
| 1174644520 | Mary Louise Pisculli | Internal Medicine | 15 Francis Street, Brigham & Women's Hospital, Boston, MA 02115 | 2007-04-03 |
| 1891889358 | Evan Matthew Hall | Physician Assistant | 15 Francis Street, Boston, MA 02115 | 2006-10-02 |
| 1619983053 | Glen M Kim | Internal Medicine | 15 Francis Street, Pbb-b-428, Boston, MA 02115 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720608912 | John Eastman | Physician Assistant | 243b Savin Hill Ave, Boston, MA 02125-1003 | 2020-04-17 |
| 1366006330 | Theresa Fukuda | Physician Assistant | 43 Bowdoin St Apt 2f, Boston, MA 02114-4238 | 2019-04-25 |
| 1649645201 | Andrew R Phenix | Physician Assistant | 75 Francis Street, Pbb-b 428, Brigham and Women's Hospital, Boston, MA 02115 | 2015-12-08 |
| 1346636123 | Julie Baskind Gilman | Physician Assistant | 800 Washington St # 401, Tufts Gma, Boston, MA 02111-1552 | 2015-04-08 |
| 1356688030 | Kevin Murtha | Physician Assistant | 6225 Shero Rd, Boston, NY 14025-9707 | 2013-01-15 |
| 1750560348 | Gretchen Haley Biggins | Physician Assistant | 44 Binney St # D1b30, Boston, MA 02115-6013 | 2007-10-30 |
| 1538290549 | Stephen Herrington Robinson | Physician Assistant | One Boston Medical Place, Boston, MA 02118 | 2007-03-08 |
| 1518057306 | Maha B Lund | Physician Assistant | 75 Francis St # Pbb-b4, Boston, MA 02115-6110 | 2006-10-13 |
| 1346287067 | Kathleen Fischer | Physician Assistant | 150 South Huntington Ave., Va Boston Healthcare System, Boston, MA 02130 | 2006-06-01 |
| 1659332799 | Cristobal Cornejo Jr. | Physician Assistant | 360 Huntington Ave, 135 Forsyth Building, Boston, MA 02115-5005 | 2006-03-29 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.