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KELLY WILMARTH C-FNP
NPI 1588072474
Nurse Practitioner in Johnson City, NY

Active since July 24, 2014PECOS Enrolled
401 MAIN ST STE 1, JOHNSON CITY, NY 13790(607) 754-9870(607) 785-9862 Get Directions Write a Review

NPPES record last updated: September 17, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 17, 2021, Mar 18, 2021, Mar 31, 2017 (3 updates tracked since 2017).

About Kelly Wilmarth C-fnp NPPES

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

KELLY WILMARTH C-FNP (NPI 1588072474) is an individual nurse practitioner in Johnson City, New York, licensed in New York (338979) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588072474
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKELLY WILMARTHCredential: C-FNP
Location Address401 MAIN ST STE 1Johnson City, NY 13790-2065
Mailing Address401 Main St Ste 1Johnson City, NY 13790-2065 · (607) 754-9870 · Fax (607) 785-9862
Phone(607) 754-9870
Fax(607) 785-9862
Sole ProprietorYes
Enumeration DateJuly 24, 2014
Last NPPES UpdateSeptember 17, 20213 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2021
✔ NPI 1588072474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in NY · 338979
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
401 MAIN ST STE 1, Johnson City, NY 13790
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Wilmarth C-fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Kelly Wilmarth reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Womens Obgyn PC
Same address
Obstetrics & Gynecology
401 MAIN ST, 1ST FLR.
Johnson City, NY 13790
  • Reassigned Medicare billing, New York enrollment
  • 24 clinicians in this Medicare group
NPI 1083079198 (607) 754-9870
Our Lady Of Lourdes Memorial Hospital, Inc.
2.1 mi
Family Medicine
169 RIVERSIDE DR
Binghamton, NY 13905
  • Reassigned Medicare billing, New York enrollment
  • 386 clinicians in this Medicare group
NPI 1063557189 (607) 584-5459

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13790 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
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 6

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

TAMARA BURGER CNM
Advanced Practice Midwife
401 MAIN ST STE 1
JOHNSON CITY, NY 13790
Broome County (607) 754-9870
KAREN CASTORO FNP
Nurse Practitioner (Family)
401 MAIN ST STE 1
JOHNSON CITY, NY 13790
Broome County (607) 754-9870
MELODYE ELAINE ONYSKO NP/CNM
Nurse Practitioner (Adult Health)
401 MAIN ST STE 1
JOHNSON CITY, NY 13790
Broome County (607) 754-9870
CAROL MILLER MD
Obstetrics & Gynecology
401 MAIN ST STE 1
JOHNSON CITY, NY 13790
Broome County (607) 754-9870
MARIANNE DAVIS D.O.
Obstetrics & Gynecology
401 MAIN ST STE 1
JOHNSON CITY, NY 13790
Broome County (607) 754-9870
AMY MARIE HAWLEY NP
Nurse Practitioner (Family)
401 MAIN ST STE 1
JOHNSON CITY, NY 13790
Broome County (607) 754-9870

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 Wilmarth's NPI number?

The NPI number for Kelly Wilmarth is 1588072474. It was assigned to this individual provider in the NPPES registry on July 24, 2014.

Where is Kelly Wilmarth located?

Kelly Wilmarth practices at 401 Main St Ste 1, Johnson City, NY 13790. The listed phone number is (607) 754-9870.

What is Kelly Wilmarth's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kelly Wilmarth enrolled in Medicare?

Yes. Kelly Wilmarth is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kelly Wilmarth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Wilmarth reassigns Medicare benefits to 2 organizations: Womens Obgyn PC (Johnson City, NY) and Our Lady Of Lourdes Memorial Hospital, Inc. (Binghamton, NY). 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 Kelly Wilmarth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Wilmarth was last updated on September 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.