KELLY PATRICK – Speech-Language Pathologist, NPI 1902688534

KELLY PATRICK is a healthcare provider. based in Jeannette, Pennsylvania. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. SL008299 (PA). The NPI Number for KELLY PATRICK is 1902688534

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
KELLY PATRICK
NPI
1902688534
Phone
Not provided
Address
2030 ADER RD
Enumeration Date
18 October 2023
Last Update Date
18 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7243273557
Graduation Year
2004 (22 years ago)
PAC ID
6002263613
Group Practice PAC ID
5294998035
Professional Enrollment ID
I20231103000169
Address ID
PA156444500JE2030XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

357 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in PA

Provider Addresses for KELLY PATRICK

  • 2030 ADER RD

    JEANNETTE, PA 156444500

    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: 2023-11-03

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
I20231103000169IQualified Speech Language PathologistPATBD

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 15644)

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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: 5294998035View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWV
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticePA
Occupational Therapist In Private PracticePA
Occupational Therapist In Private PracticeOH
Occupational Therapist In Private PracticePA
Qualified Speech Language PathologistPA
Physical Therapist In Private PracticePA
Physical Therapist In Private PracticeOH
Physical Therapist In Private PracticePA

Reviews

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Frequently asked questions

Can I verify KELLY PATRICK with an NPI only?
You can start verification with NPI 1902688534 for KELLY PATRICK, then check state licensing separately.
Can I rely on KELLY PATRICK being an active provider?
As of the registry snapshot, KELLY PATRICK is marked active.
What is KELLY PATRICK's primary classification?
Speech-Language Pathologist is the headline specialty for KELLY PATRICK here. Clinical services aligned with this taxonomy classification.
What area does KELLY PATRICK serve?
KELLY PATRICK's listing highlights Jeannette, Pennsylvania; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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