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KELLIANNE TULLEY
NPI 1760842637
Physician Assistant in Merrick, NY

Active since March 04, 2016PECOS EnrolledAccepts Medicare Assignment
84.47/100
CMS Quality Rating
21 WOODBINE AVE, MERRICK, NY 11566(516) 663-8963 Get Directions Write a Review

NPPES record last updated: June 28, 2023. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: May 13, 2019, Mar 4, 2016 (2 updates tracked since 2016).

About Kellianne Tulley NPPES

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

KELLIANNE TULLEY (NPI 1760842637) is an individual physician assistant in Merrick, New York, licensed in New York (19479) and active in the NPI registry since March 2016. She is enrolled in Medicare PECOS, is affiliated with Nyu Langone Hospitals, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1760842637
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELLIANNE TULLEY
Location Address21 WOODBINE AVEMerrick, NY 11566-3130
Mailing Address21 Woodbine AveMerrick, NY 11566-3130
Phone(516) 663-8963
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMarch 4, 2016
Last NPPES UpdateJune 28, 20232 updates tracked since enumeration
✔ NPI 1760842637 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 NY · 19479
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.
21 WOODBINE AVE, Merrick, NY 11566
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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

Kellianne Tulley 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 ID3678856457
PECOS Enrollment IDI20170202001147
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

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

Nyu Langone Hospitals

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330214
Location550 First AvenueNew York, NY 10016 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11566 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.33
Promoting Interoperability100
Improvement Activities40
Cost54.91

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 Kellianne Tulley's NPI number?

The NPI number for Kellianne Tulley is 1760842637. It was assigned to this individual provider in the NPPES registry on March 4, 2016.

Where is Kellianne Tulley located?

Kellianne Tulley practices at 21 Woodbine Ave, Merrick, NY 11566. The listed phone number is (516) 663-8963.

What is Kellianne Tulley's specialty?

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

Is Kellianne Tulley enrolled in Medicare?

Yes. Kellianne Tulley 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 Kellianne Tulley affiliated with any hospitals?

According to CMS data, Kellianne Tulley is affiliated with Nyu Langone Hospitals.

When was this NPI record last updated?

The NPPES record for Kellianne Tulley was last updated on June 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.