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MARY ALICE DISSELKAMP PA-C
NPI 1043876170
Physician Assistant in Elizabethtown, KY

Active since May 14, 2019PECOS EnrolledAccepts Medicare Assignment
89.82/100
CMS Quality Rating
2407 RING RD STE 108, ELIZABETHTOWN, KY 42701(270) 706-5787(270) 706-5788 Get Directions Write a Review

NPPES record last updated: November 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 8, 2023, May 14, 2019 (2 updates tracked since 2019).

About Mary Alice Disselkamp Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY ALICE DISSELKAMP PA-C (NPI 1043876170) is an individual physician assistant in Elizabethtown, Kentucky and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Hardin, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1043876170
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMARY ALICE DISSELKAMPCredential: PA-C
Location Address2407 RING RD STE 108Elizabethtown, KY 42701-5938
Mailing Address2407 Ring Rd Ste 108Elizabethtown, KY 42701-5938 · (270) 706-5787 · Fax (270) 706-5788
Phone(270) 706-5787
Fax(270) 706-5788
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 14, 2019
Last NPPES UpdateNovember 8, 20232 updates tracked since enumeration
NPPES CertifiedNovember 8, 2023
✔ NPI 1043876170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2407 RING RD STE 108, Elizabethtown, KY 42701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mary Alice Disselkamp Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971834557
PECOS Enrollment IDI20191011002558
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Dxa bone density measurement of hip, pelvis, spine 77080
A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
784 services784 patients
Dxa bone density measurement of hip, pelvis, spine 77080
A DXA bone density measurement is a simple, quick, and non-invasive procedure that assesses the strength of your bones. This test uses X-rays to measure the amount of minerals, mainly calcium, in the hip, pelvis, and spine. It helps in early detection of osteoporosis or other bone diseases.
287 services287 patients
Drainage of fluid from abdominal cavity using imaging guidance 49083
This procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.
154 services40 patients
Fluoroscopic guidance for needle placement 77002
Fluoroscopic guidance for needle placement is a medical procedure that uses a special X-ray technology to help accurately place a needle in the body. It's often used in biopsies, injections or other treatments to ensure precision and safety.
74 services66 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
73 services65 patients
Removal of spinal fluid with lower back spinal tap for diagnostic test using imaging guidance 62328
A lower back spinal tap, guided by imaging, is a procedure to collect spinal fluid for testing. A needle is carefully inserted into the lower back to draw out fluid. This can help diagnose various conditions. It's performed under local anesthesia to minimize discomfort.
35 services34 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Hardin

Acute Care Hospitals · Elizabethtown, KY
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number180012
Location913 North Dixie AvenueElizabethtown, KY 42701 · Hardin County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality96.92
Improvement Activities40
Cost71.7

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL R KRUEGER MD PLLC
Orthopaedic Surgery
2407 RING RD STE 108
ELIZABETHTOWN, KY 42701
Hardin County (270) 735-1588
HARDIN PROFESSIONAL SERVICES, LLC
Radiology (Diagnostic Radiology)
2407 RING RD STE 108
ELIZABETHTOWN, KY 42701
Hardin County (270) 735-1588
JOSEPH D SEGO PA
Physician Assistant
2407 RING RD STE 108
ELIZABETHTOWN, KY 42701
Hardin County (270) 735-1588
KATHERINE M. COLLIN PA-C
Physician Assistant
2407 RING RD STE 108
ELIZABETHTOWN, KY 42701
Hardin County (270) 706-5787

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Disselkamp's NPI number?

The NPI number for Mary Disselkamp is 1043876170. It was assigned to this individual provider in the NPPES registry on May 14, 2019.

Where is Mary Disselkamp located?

Mary Disselkamp practices at 2407 Ring Rd Ste 108, Elizabethtown, KY 42701. The listed phone number is (270) 706-5787.

What is Mary Disselkamp's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mary Disselkamp enrolled in Medicare?

Yes. Mary Disselkamp is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Disselkamp accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Mary Disselkamp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mary Disselkamp affiliated with any hospitals?

According to CMS data, Mary Disselkamp is affiliated with Baptist Health Hardin.

When was this NPI record last updated?

The NPPES record for Mary Disselkamp was last updated on November 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.