Individual provider Active NPI

David B Kasprzak, CRNP

  • Family Nurse Practitioner
  • Tamaqua, PA
National Provider Identifier
1043654197
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP025725 Issued in PA
Practice address
229 W Broad St
Tamaqua, PA 18252-1818
Phone
(570) 657-1634
NPI assigned
Apr 19, 2013
Last updated
Jun 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP025725 PA Primary
Urology Registered Nurse 163WU0100X RN289685L PA

Addresses

Primary practice location

229 W Broad St
Tamaqua, PA 18252-1818

Mailing address

10 W White Bear Dr
Summit Hill, PA 18250-1728
Phone (570) 657-1634

Other practice location 1

10 W White Bear Dr
Summit Hill, PA 18250-1728
Phone (570) 657-1634

Other identifiers 1

IdentifierTypeStateIssuer
SP025725OtherPACRNP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20220713003517 PA Practitioner - Nurse Practitioner 6103206586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

229 W Broad St
Tamaqua, PA 18252-1818
Phone (570) 657-1634

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN289685LPAMDUrology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Critical Care LTD CurrentSince Jan 1, 1990 Accepting new patients
Northeast Critical Care LTD Past Accepting new patients
Northeast Critical Care Clinical Labs Past Accepting new patients

Organizations & group practices 3

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1043654197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W WHITE BEAR DR",
            "city": "SUMMIT HILL",
            "state": "PA",
            "postal_code": "182501728",
            "telephone_number": "570-657-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W BROAD ST",
            "city": "TAMAQUA",
            "state": "PA",
            "postal_code": "182521818",
            "telephone_number": "570-657-1634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 W White Bear Dr",
            "address_purpose": "LOCATION",
            "city": "Summit Hill",
            "state": "PA",
            "postal_code": "182501728",
            "country_code": "US",
            "telephone_number": "570-657-1634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASPRZAK",
        "first_name": "DAVID",
        "middle_name": "B",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-19",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP025725",
            "primary": true
        },
        {
            "code": "163WU0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Urology",
            "state": "PA",
            "license": "RN289685L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNP",
            "identifier": "SP025725",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamaqua, PA

Sources for this page

Verify at the official NPI Registry.