KELLY CZWORKA (NP) – Nurse Practitioner, NPI 1104984251

KELLY CZWORKA (NP) is a healthcare provider. based in Andover, Massachusetts. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 264560 (MA). The NPI Number for KELLY CZWORKA (NP) is 1104984251

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
KELLY CZWORKA (NP)
NPI
1104984251
Phone
(978) 783-5000
Address
323 LOWELL ST
Enumeration Date
4 December 2006
Last Update Date
20 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9785578900
Graduation Year
2006 (20 years ago)
PAC ID
7113928441
Group Practice PAC ID
1759273436
Professional Enrollment ID
I20070129000631
Address ID
MA018431981LA500XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

8,971 NURSE PRACTITIONER in MA

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Provider Addresses for KELLY CZWORKA (NP)

  • 323, Lowell Street, Andover, Essex County, Massachusetts, 01810, United States

    ANDOVER, MA 018104501

    Phone: (978) 783-5000

    Fax: (978) 313-8184

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-01-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070129000631INurse PractitionerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes13994$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit3838$0
99213Established patient office or other outpatient visit, 20-29 minutes2423$0
G0008Administration of influenza virus vaccine1715$0
90662Influenza vaccine split virus, preservative free1312$0
View full utilization report →

Insurance plans in this area (ZIP 01810)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759273436View full group profile
NameSpecialtyState
P A T H O L O G YMA
Nurse PractitionerNY
Diagnostic RadiologyME
Physician AssistantMA
Diagnostic RadiologyMI
Diagnostic RadiologyMA
Diagnostic RadiologyOH
P A T H O L O G YMA
Family Practice, Osteopathic Manipulative MedicineMA
Diagnostic Radiology, Interventional RadiologyNY

Reviews

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Frequently asked questions

What unique ID ties claims to KELLY CZWORKA (NP)?
NPI 1104984251 is assigned to KELLY CZWORKA (NP) under the national enumeration system.
Is KELLY CZWORKA (NP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is KELLY CZWORKA (NP)?
The page reflects Nurse Practitioner for KELLY CZWORKA (NP). Clinical services aligned with this taxonomy classification.
What location shows for KELLY CZWORKA (NP)?
We surface Andover, Massachusetts for KELLY CZWORKA (NP) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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