Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Witucki, PA-C

Individual provider Physician Assistant · NPI 1649150822

Kelly Witucki, PA-C is a Physician Assistant in Maplewood, Minnesota. Qualified in 2025, 1 year ago. Practices with Emergency Care Consultants PA, a 105-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
1
Licensed in
MN
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1575 Beam Ave
Maplewood, MN 55109-1126
Phone: (651) 232-7348
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15652 (MN)

Record details

NPI number1649150822
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 6, 2025
Last updated in NPPESJanuary 22, 2026
Certification dateJanuary 22, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Emergency Care Consultants Pa — 105 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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