KELLY LAUREN CEDERQUIST PA-C
NPI 1669815965
Physician Assistant - Medical in Philadelphia, PA
About Kelly Lauren Cederquist Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY LAUREN CEDERQUIST PA-C (NPI 1669815965) is an individual medical provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MA056112) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Lauren Cederquist 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.
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
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 Cederquist's NPI number?
The NPI number for Kelly Cederquist is 1669815965. It was assigned to this individual provider in the NPPES registry on April 17, 2013.
Where is Kelly Cederquist located?
Kelly Cederquist practices at 3400 Spruce St, Philadelphia, PA 19104. The listed phone number is (215) 662-6200.
What is Kelly Cederquist's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Kelly Cederquist enrolled in Medicare?
Yes. Kelly Cederquist is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kelly Cederquist was last updated on May 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Kelly Lauren Cederquist, PA-C · NPI 1669815965
Medical physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since April 17, 2013.
## Identity
- **NPI:** 1669815965 (Entity type: Individual)
- **Enumerated:** April 17, 2013
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** MA056112 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 3400 SPRUCE ST, Philadelphia, PA 19104-4206
- **Phone:** (215) 662-6200
## 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:** May 7, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1669815965) · Data from the CMS NPPES public registry.