Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Ann Bevilaqua-Tracy, PA

Individual provider Physician Assistant · NPI 1114179637

Kelly Ann Bevilaqua-Tracy, PA is a Physician Assistant in Scranton, Pennsylvania. Qualified in 2008, 18 years ago. Practices with Geisinger Clinic, a 3,413-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
18
Licensed in
PA
In the registry since
2008
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1800 Mulberry St
Scranton, PA 18510-2369
Phone: (570) 703-4830
Fax: (570) 703-4835
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA053585 (PA)

Record details

NPI number1114179637
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 15, 2008
Last updated in NPPESDecember 30, 2020
Certification dateDecember 30, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Geisinger Clinic — 3413 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Scranton