KELLEY MARIE DICKSON DO
NPI 1366071425
Family Medicine in Springfield, PA
About Kelley Marie Dickson Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLEY MARIE DICKSON DO (NPI 1366071425) is an individual family medicine provider in Springfield, Pennsylvania, licensed in Pennsylvania (OS022928) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kelley Marie Dickson Do 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.
Medicare Billing Reassignments
3Medicare enrollment records show Kelley Dickson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Springfield, PA 19064
- Reassigned Medicare billing, Pennsylvania enrollment
- 654 clinicians in this Medicare group
Chester, PA 19013
- Reassigned Medicare billing, Pennsylvania enrollment
- 39 clinicians in this Medicare group
Bala Cynwyd, PA 19004
- Reassigned Medicare billing, Pennsylvania enrollment
- 192 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Hospital Of Univ Of Pennsylvania
Acute Care Hospitals · Philadelphia, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19064 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Kelley Dickson's NPI number?
The NPI number for Kelley Dickson is 1366071425. It was assigned to this individual provider in the NPPES registry on April 2, 2020.
Where is Kelley Dickson located?
Kelley Dickson practices at 1260 E. Woodland Ave Ste 200, Springfield, PA 19064. The listed phone number is (610) 690-4490.
What is Kelley Dickson's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kelley Dickson enrolled in Medicare?
Yes. Kelley Dickson 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.
Which organizations bill Medicare for Kelley Dickson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelley Dickson reassigns Medicare benefits to 3 organizations: Prospect Health Access Network, Inc. (Springfield, PA), Chespenn Health Services (Chester, PA) and Clinical Specialty Associates (Bala Cynwyd, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelley Dickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kelley Dickson affiliated with any hospitals?
According to CMS data, Kelley Dickson is affiliated with Hospital Of Univ Of Pennsylvania.
When was this NPI record last updated?
The NPPES record for Kelley Dickson was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.
# Kelley Marie Dickson, DO · NPI 1366071425
Family Medicine physician in Springfield, Pennsylvania. Individual provider, active in the CMS NPPES registry since April 2, 2020.
## Identity
- **NPI:** 1366071425 (Entity type: Individual)
- **Enumerated:** April 2, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** OS022928 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 1260 E. WOODLAND AVE, STE 200, Springfield, PA 19064-3956
- **Phone:** (610) 690-4490 · **Fax:** (610) 328-9391
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Prospect Health Access Network, Inc. (NPI 1871948414, Springfield, PA); Chespenn Health Services (NPI 1750329603, Chester, PA); Clinical Specialty Associates (NPI 1033902002, Bala Cynwyd, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** December 4, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1366071425) · Data from the CMS NPPES public registry.