NPIMap

Individual provider Active NPI

Haley Danielle Kamenik, PA-C

  • Physician Assistant
  • Galion, OH
National Provider Identifier
1043447311
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.002890 Issued in OH
Practice address
269 Portland Way S
Galion, OH 44833-2312
Phone
(419) 468-4841
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.002890 OH Primary

Addresses

Primary practice location

269 Portland Way S
Galion, OH 44833-2312

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Other identifiers 2

IdentifierTypeStateIssuer
H403852OtherOHMEDICARE
0090732MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hbartholemew539873@direct.osumc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Marion County Emergency Physicians Inc Emergency Medicine CurrentSince Nov 1, 2014 Accepting new patients
Galion Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Marion General Hospital Foundation, Inc. Emergency Medicine Past Accepting new patients
Marion Physician Billing LLC Emergency Medicine Past Accepting new patients

Locations

4750 Hempstead Station Dr
Kettering, OH 45429

1000 McKinley Park Dr
Marion, OH 43302
Phone (740) 383-8400

Interoperability endpoints

  • Direct secure messaging: hbartholemew539873@direct.osumc.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1043447311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 PORTLAND WAY S",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332312",
            "telephone_number": "419-468-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMENIK",
        "first_name": "HALEY",
        "middle_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H403852",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090732",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hbartholemew539873@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "269 Portland Way S",
            "city": "Galion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "448332312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Galion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.