Kristina M Jackowiak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2824 Elkhart Rd
Goshen, IN 46526-1014

Phone

(574) 535-1700

NPI assigned

Mar 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristina M Appelhans Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Goshen Hospital Hospital, Goshen, IN, CCN 150026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristina.jackowiak@goshenhealthdirect.com
• Direct secure messaging: kristina.appelhans@goshenhealthdirect.com

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.

• Goshen Health System Inc

  • Family Medicine Physician
  • Goshen, IN
  • NPI 1194772293
  Medicare reassignment Care Compare group NPD
• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Goshen Hospital Association Inc

  • General Acute Care Hospital
  • Goshen, IN
  • NPI 1740268846
  Care Compare affiliation

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1043551401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261014",
            "telephone_number": "574-535-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKOWIAK",
        "first_name": "KRISTINA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristina.appelhans.p1@direct.goshenphysicians.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2824 Elkhart Rd",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465261014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristina.jackowiak@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2824 Elkhart Rd",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465261014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "APPELHANS",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Goshen, IN
• Providers in Goshen, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.