1. Home
  2. Directory
  3. Pennsylvania
  4. Scranton
  5. Physician Assistant
  6. NPI Profile

KELLY ANN BEVILAQUA-TRACY PA
NPI 1114179637
Physician Assistant in Scranton, PA

Active since October 15, 2008PECOS EnrolledAccepts Medicare Assignment
1800 MULBERRY ST, SCRANTON, PA 18510(570) 703-4830(570) 703-4835 Get Directions Write a Review

NPPES record last updated: December 30, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 30, 2020, Dec 17, 2019 (2 updates tracked since 2019).

About Kelly Ann Bevilaqua-tracy Pa NPPES

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

KELLY ANN BEVILAQUA-TRACY PA (NPI 1114179637) is an individual physician assistant in Scranton, Pennsylvania, licensed in Pennsylvania (MA053585) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS, is affiliated with Geisinger-community Medical Center, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1114179637
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELLY ANN BEVILAQUA-TRACYCredential: PA
Location Address1800 MULBERRY STScranton, PA 18510-2369
Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 271-6144 · Fax (570) 271-6578
Phone(570) 703-4830
Fax(570) 703-4835
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateOctober 15, 2008
Last NPPES UpdateDecember 30, 20202 updates tracked since enumeration
NPPES CertifiedDecember 30, 2020
✔ NPI 1114179637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in PA · MA053585
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.
1800 MULBERRY ST, Scranton, PA 18510
Open in Google Maps ↗

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

Kelly Ann Bevilaqua-tracy Pa 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 ID9335200971
PECOS Enrollment IDI20081202000120
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.

Hospital Affiliations CMS Care Compare 2

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

Geisinger-Community Medical Center

Acute Care Hospitals · Scranton, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390001
Location1822 Mulberry StreetScranton, PA 18510 · Lackawanna County
Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390270
Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18510 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

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.

DR. RAJAGOPALAN RENGAN D.O
Internal Medicine (Pulmonary Disease)
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 969-0161
FELICIA RZESZEWSKI DNP
Nurse Anesthetist, Certified Registered
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 703-8259
EMILY TEMPLE RN
Registered Nurse (Medical-Surgical)
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 703-8000
AMY CLIFFORD-CARTWRIGHT RD, LDN
Dietitian, Registered
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 703-8084
RITU KHURANA M.D.
Internal Medicine (Rheumatology)
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 703-7351
FITZGERALD JUNIOR CASIMIR MD
Surgery
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 703-7245
TARA A MCCANTS RN
Nurse Anesthetist, Certified Registered
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 703-8259
CHELSEA LYNN ERIE FNP-C
Nurse Practitioner
1800 MULBERRY ST
SCRANTON, PA 18510
Lackawanna County (570) 703-4954

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 Bevilaqua-tracy's NPI number?

The NPI number for Kelly Bevilaqua-tracy is 1114179637. It was assigned to this individual provider in the NPPES registry on October 15, 2008.

Where is Kelly Bevilaqua-tracy located?

Kelly Bevilaqua-tracy practices at 1800 Mulberry St, Scranton, PA 18510. The listed phone number is (570) 703-4830.

What is Kelly Bevilaqua-tracy's specialty?

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

Is Kelly Bevilaqua-tracy enrolled in Medicare?

Yes. Kelly Bevilaqua-tracy 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.

Is Kelly Bevilaqua-tracy affiliated with any hospitals?

According to CMS data, Kelly Bevilaqua-tracy is affiliated with Geisinger-Community Medical Center and Geisinger Wyoming Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Kelly Bevilaqua-tracy was last updated on December 30, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.