Active NPI 1477529501 Individual Practitioner Male Practitioner

Kyle Fetterolf , PA

Physician Assistant • Kingston, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Kyle Fetterolf, PA is a certified Physician Assistant practicing in Kingston, PA. With approximately 27 years of clinical experience since completing medical education in 1999, Kyle Fetterolf delivers high-quality medical care to the local community at 423 3RD AVE STE B.

Kyle Fetterolf is affiliated with Commonwealth Physician Network Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, detection test by immunoassay with direct visual observation for influenza virus. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

423 3rd Ave Ste B

Kingston, PA 187045809

Telephone 5702883601

Fax 5702881726

Associated Practice Facility / Clinic

🏢 C. N. Burns, Jr., M.d. Facility NPI 1336280163

Medicare Profile & Education

Medical School

Other

Graduation Year

1999

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Kingston, PA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

27 Yrs +14.4 yrs vs City Avg

City Avg: 12.6 Yrs

State Avg: 11.5 Yrs

Regional Practice Density

25 Specialists

Practicing in Kingston, PA (8068 Statewide)

Telehealth Adoption Rate

24.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

81.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fetterolf (27 Years) 27 Yrs

Kingston Specialty Average (12.6 Years) 12.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	151	134	$225.00	$72.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	82	82	$240.00	$89.91
87804 Detection test by immunoassay with direct visual observation for influenza virus	78	36	$50.00	$15.80
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	54	49	$80.00	$39.80
99285 Emergency department visit for life threatening or functioning severity	33	33	$1528.18	$141.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	30	$240.00	$103.08
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	26	26	$50.00	$15.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$300.00	$134.91
81003 Automated urinalysis test	20	19	$30.00	$2.20
99284 Emergency department visit with moderate level of medical decision making	19	19	$1116.58	$98.21
71046 X-ray of chest, 2 views	13	13	$91.27	$9.43
90471 Administration of 1 vaccine	11	11	$47.45	$16.34
90714 Vaccine for tetanus and diphtheria toxoids injection into muscle, patient 7 years or older	11	11	$74.91	$31.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	227	222	$1400.00	$144.42
99284 Emergency department visit with moderate level of medical decision making	107	105	$935.00	$99.76
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	75	71	$73.00	$6.57
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	28	27	$240.00	$103.79
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$300.00	$135.57
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	17	17	$80.00	$40.55
99283 Emergency department visit with low level of medical decision making	14	14	$645.00	$59.32
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$225.00	$73.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	346	337	$1400.00	$147.77
99284 Emergency department visit with moderate level of medical decision making	115	110	$935.00	$101.80
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	99	96	$73.00	$6.85
99283 Emergency department visit with low level of medical decision making	37	37	$645.00	$60.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	184	184	$1400.00	$152.04
99284 Emergency department visit with moderate level of medical decision making	106	103	$935.00	$103.62
99283 Emergency department visit with low level of medical decision making	78	78	$645.00	$61.29
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	43	42	$73.00	$7.03
99282 Emergency department visit with straightforward medical decision making	14	14	$355.00	$36.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	307	295	$1400.00	$149.51
99284 Emergency department visit with moderate level of medical decision making	106	105	$935.00	$102.69
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	93	87	$73.00	$7.26
99283 Emergency department visit with low level of medical decision making	38	37	$645.00	$55.94
99282 Emergency department visit with straightforward medical decision making	11	11	$355.00	$37.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	229	224	$1274.15	$146.66
99284 Emergency department visit with moderate level of medical decision making	100	97	$878.45	$99.51
99283 Emergency department visit with low level of medical decision making	72	69	$575.00	$52.47
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	70	67	$69.49	$7.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	287	283	$1180.00	$145.77
99284 Emergency department visit with moderate level of medical decision making	124	123	$790.00	$99.36
99283 Emergency department visit with low level of medical decision making	79	79	$505.00	$52.34
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	71	71	$67.00	$7.11
99282 Emergency department visit with straightforward medical decision making	13	12	$336.00	$34.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity	238	234	$1180.00	$145.15
99284 Emergency department visit with moderate level of medical decision making	154	149	$790.00	$98.74
99283 Emergency department visit with low level of medical decision making	103	102	$505.00	$52.09
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	79	78	$67.00	$6.99
99282 Emergency department visit with straightforward medical decision making	16	16	$336.00	$34.77
12001 Repair of wound (2.5 centimeters or less) of the scalp, neck, underarms, trunk, arms and/or legs	11	11	$226.00	$37.62

Medical Specialties & State Licenses

CMS Verified: 2025-02-13

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License PA MA001889L

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Commonwealth Physician Network Llc

4 E Main St, Nanticoke, PA 186341602

Phone: 5707357474

Commonwealth Physician Network Llc

423 3rd Ave, Kingston, PA 187045809

Phone: 5702883601

Commonwealth Physician Network Llc

575 N River St, Wilkes Barre, PA 187022634

Phone: 5705528938

Secondary Practice Locations

575 N River St

Wilkes Barre, PA 187640999

Phone: 5702709192

334 Main St

Dickson City, PA 185191668

Phone: 8889526772

677 Kidder St Ste D

Wilkes Barre Township, PA 187026914

Phone: 5708252046

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Dr. Daniel Rittenberg , MD

Urology

NPI 1164840682

Doctor of Medicine (M.D.)

Dr. Crescenzo Calise , MD

Specialist

NPI 1629038401

Doctor of Medicine (M.D.)

Denise Hoffman , PA-C

Physician Assistant

NPI 1821458217

Physician Assistant (Certified)

Dr. Michael Rittenberg , MD

Specialist

NPI 1942261375

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location February 13, 2025

Registered at 423 3RD AVE STE B, KINGSTON, PA 187045809 (Tel: 5702883601)

📍

Updated Business Mailing Address February 13, 2025

Registered at 423 3RD AVE STE B, KINGSTON, PA 187045809 (Tel: 5702883601)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 575 N RIVER ST, WILKES BARRE, PA 187640999 (Tel: 5702709192)

📍

Updated Business Mailing Address July 08, 2007

Registered at PO BOX 349, DUNMORE, PA 185120349

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as KYLE FETTEROLF, PA

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #MA001889L in PA)

🟢

Initial NPI Registration & Enumeration February 28, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477529501

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 28, 2006

Last Update: February 13, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

423 3rd Ave Ste B

Kingston, PA 187045809

Phone: 5702883601

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.