KELLY KERR – Physician Assistant, NPI 1063255057

KELLY KERR is a healthcare provider. based in Poughkeepsie, New York. specializing in PHYSICIAN ASSISTANT. The NPI Number for KELLY KERR is 1063255057

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
KELLY KERR
NPI
1063255057
Phone
Not provided
Address
3399 NORTH RD
Enumeration Date
17 June 2024
Last Update Date
17 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2024 (2 years ago)
PAC ID
4981137320
Group Practice PAC ID
9638177900
Professional Enrollment ID
I20241024000611
Address ID
NJ070390000LI22XXXRDXX518
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

13,244 PHYSICIAN ASSISTANT in NY

Provider Addresses for KELLY KERR

  • 3399 NORTH RD

    POUGHKEEPSIE, NY 126011387

    Phone:

    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: 2024-10-24

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
I20241024000611IPhysician AssistantNJTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 12601)

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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: 9638177900View full group profile
NameSpecialtyState
Physician AssistantPA
Infectious Disease, Internal MedicineNJ
Physician AssistantNJ
Infectious Disease, Internal MedicineNJ
Physician AssistantNJ
Physician AssistantNJ
Internal MedicinePA
-NJ
-NJ
Physician AssistantWI

Reviews

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Frequently asked questions

Can I use this page to confirm KELLY KERR's NPI?
Yes. KELLY KERR is listed with NPI 1063255057 in the public NPI dataset.
Can I rely on KELLY KERR being an active provider?
As of the registry snapshot, KELLY KERR is marked active.
What healthcare role does KELLY KERR hold?
Scheduling teams often label KELLY KERR under Physician Assistant. Clinical services aligned with this taxonomy classification.
Does KELLY KERR list a practice location?
Patients near Poughkeepsie, New York may find KELLY KERR in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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