MRS. KELLY MITZEN PA-C
NPI 1073584777
Physician Assistant - Medical in Fort Myer, VA
About Mrs. Kelly Mitzen Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KELLY MITZEN PA-C (NPI 1073584777) is an individual medical provider in Fort Myer, Virginia, licensed in Virginia (0110002992) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Kelly Mitzen Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FT MYER, VA 22211
ARLINGTON, VA 22211
FT MYER, VA 22211
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 Kelly Mitzen's NPI number?
The NPI number for Kelly Mitzen is 1073584777. It was assigned to this individual provider in the NPPES registry on January 30, 2006.
Where is Kelly Mitzen located?
Kelly Mitzen practices at 401 Carpenter Rd, Fort Myer, VA 22211. The listed phone number is (703) 966-7935.
What is Kelly Mitzen's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Kelly Mitzen enrolled in Medicare?
Yes. Kelly Mitzen is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kelly Mitzen was last updated on July 30, 2024. 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.
# Mrs. Kelly Mitzen, PA-C · NPI 1073584777
Medical physician in Fort Myer, Virginia. Individual provider, active in the CMS NPPES registry since January 30, 2006.
## Identity
- **NPI:** 1073584777 (Entity type: Individual)
- **Enumerated:** January 30, 2006
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** 0110002992 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 401 CARPENTER RD, Fort Myer, VA 22211-1009
- **Phone:** (703) 966-7935
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 30, 2024
- **Other identifiers:** Other 1073584777
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Source: [NPI Profile](https://npiprofile.com/npi/1073584777) · Data from the CMS NPPES public registry.