Kelly Christine Mutsavage, PA-C is a medicare enrolled "Dermatology" physician in Meadville, Pennsylvania. Her current practice location is
640 Alden St, Meadville, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(814) 724-1252.
Kelly Christine Mutsavage is licensed to practice in Pennsylvania (license number MA052475) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1487601886.
Physician's Profile
Full Name | Kelly Christine Mutsavage |
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Gender | Female |
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Speciality | Dermatology |
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Location | 640 Alden St, Meadville, Pennsylvania |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487601886
- Provider Enumeration Date: 05/30/2006
- Last Update Date: 06/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 0840202826
- Enrollment ID: I20060612000054
Medical Identifiers
Medical identifiers for Kelly Christine Mutsavage such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487601886 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | MA052475 (Pennsylvania) | Primary |
363A00000X | Physician Assistant | MA052475 (Pennsylvania) | Secondary |
208M00000X | Hospitalist | MA052475 (Pennsylvania) | Secondary |
363A00000X | Physician Assistant | OA002277 (Pennsylvania) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Christine Mutsavage is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelly Christine Mutsavage, PA-C 640 Alden St, Meadville, PA 16335-2348 Ph: (814) 724-1252 | Kelly Christine Mutsavage, PA-C 640 Alden St, Meadville, PA 16335-2348 Ph: (814) 724-1252 |
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