Individual provider Active NPI

Kathryn Elaine Kasyjanski, MD

  • Pediatrics Physician
  • Greenwood, IN
National Provider Identifier
1093910218
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01067996A Issued in IN
Practice address
333 E County Line Rd
Suite B
Greenwood, IN 46143-1079
Phone
(317) 497-6333
Fax
(317) 497-6334
NPI assigned
Jun 18, 2007
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01067996A IN Primary

Addresses

Primary practice location

333 E County Line Rd
Suite B
Greenwood, IN 46143-1079

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 2

IdentifierTypeStateIssuer
200986040MedicaidIN
000000711495OtherINANTHEM

Other names 1

  • Kathryn Elaine Gerlib Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkasyjanski7731@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000477 IN Practitioner - Pediatric Medicine 3971799453 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc Pediatrics CurrentSince Jul 1, 2011 Accepting new patients
Eskenazi Medical Group Inc Pediatrics CurrentSince Sep 22, 2010 Accepting new patients
Jane Pauley Community Health Center Inc CurrentSince Mar 11, 2025 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 1, 2011 Accepting new patients
Major Hospital Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

333 E County Line Rd
Greenwood, IN 46143
Phone (317) 497-6800

333 E County Line Rd
Ste B
Greenwood, IN 46143
Phone (317) 497-6333

1503 N Mitthoefer Rd
Indianapolis, IN 46229

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

8931 E 30th St
Indianapolis, IN 46219
Phone (317) 355-9320

Interoperability endpoints

  • Direct secure messaging: kkasyjanski764238@direct.ochin.org
  • Direct secure messaging: kkasyjanski7731@ecommunitydirect.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1093910218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E COUNTY LINE RD",
            "address_2": "SUITE B",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431079",
            "telephone_number": "317-497-6333",
            "fax_number": "317-497-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASYJANSKI",
        "first_name": "KATHRYN",
        "middle_name": "ELAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01067996A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200986040",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000711495",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkasyjanski7731@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "333 E County Line Rd",
            "address_2": "Suite B",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461431079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "GERLIB",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.