Mrs Kelsey Brianna Suppa, PA-C is a medicare enrolled "Physician Assistant" physician in Glen Burnie, Maryland. Her current practice location is
301 Hospital Dr, Glen Burnie, Maryland. You can reach out to her office (for appointments etc.) via phone at
(410) 787-4000.
Mrs Kelsey Brianna Suppa is licensed to practice in * (Not Available) (license number ) 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 1053700815.
Physician's Profile
Full Name | Mrs Kelsey Brianna Suppa |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 301 Hospital Dr, Glen Burnie, Maryland |
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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: 1053700815
- Provider Enumeration Date: 01/16/2015
- Last Update Date: 11/06/2023
Medicare PECOS Information:
- PECOS PAC ID: 1557674405
- Enrollment ID: I20150721001391
Medical Identifiers
Medical identifiers for Mrs Kelsey Brianna Suppa such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1053700815 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2082S0105X | Plastic Surgery - Surgery Of The Hand | C0005671 (Maryland) | Secondary |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
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. Mrs Kelsey Brianna Suppa 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 |
Mrs Kelsey Brianna Suppa, PA-C 1306 Oak Rd, Severna Park, MD 21146-3402 Ph: (410) 491-2212 | Mrs Kelsey Brianna Suppa, PA-C 301 Hospital Dr, Glen Burnie, MD 21061 Ph: (410) 787-4000 |
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