Individual provider Active NPI

Paul Alexander Kushlak, DPM

  • Foot & Ankle Surgery Podiatrist
  • Winchester, VA
National Provider Identifier
1104031731
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0103301023 Issued in VA
Practice address
117 N Braddock St
Suite 150
Winchester, VA 22601-3969
Phone
(540) 662-4572
Fax
(540) 722-9519
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901002206 MI
Foot & Ankle Surgery Podiatrist 213ES0103X 0103301023 VA Primary

Addresses

Primary practice location

117 N Braddock St
Suite 150
Winchester, VA 22601-3969

Mailing address

117 N Braddock St
Suite 150
Winchester, VA 22601-3969
Phone (540) 662-4572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091228000457 VA Practitioner - Podiatry 4183796840 Reassigns benefits to 1 organization
I20100204000442 WV Practitioner - Podiatry 4183796840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winchester Foot and Ankle Associates PLLCGroup PAC ID 6305813312, 3 clinicians

Practice addresses (Care Compare)

117 N Braddock St
Suite 150
Winchester, VA 22601-3970
Phone (540) 622-4572

207 E 5TH Ave
Ranson, WV 25438-1613
Phone (304) 725-0084

Hospital & facility affiliations

  • Valley Health Home Health/West Virginia Home health agency, Romney, WV, CCN 517075
  • Winchester Medical Center Hospital, Winchester, VA, CCN 490005
  • Shenandoah Memorial Hospital Hospital, Woodstock, VA, CCN 491305
  • Warren Memorial Hospital Hospital, Front Royal, VA, CCN 490033
  • Valley Health War Memorial Hospital Hospital, Berkeley Springs, WV, CCN 511309

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue212
Removal of skin lesions1-10
Removal of nail tissue950
Removal or shaving of skin growth583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901002206MIMDFoot & Ankle Surgery Podiatrist
0103301023VAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Foot & Ankle Associates PLLC CurrentSince Nov 9, 2000 Accepting new patients
Winchester Foot & Ankle Associates PLLC Foot & Ankle Surgery CurrentSince Nov 9, 2000 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

117 N Braddock St
Ste 150
Winchester, VA 22601
Phone (540) 622-4572

201 Augustine Ave
Charles Town, WV 25414
Phone (304) 725-0084

207 E 5th Ave
Ranson, WV 25438
Phone (304) 725-6777

205 Ambrose Dr
Unit 68
Ranson, WV 25438

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/635f51c4-b647-4331-af69-de60fc5578b8/

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1104031731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N BRADDOCK ST",
            "address_2": "SUITE 150",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013969",
            "telephone_number": "540-662-4572",
            "fax_number": "540-722-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N BRADDOCK ST",
            "address_2": "SUITE 150",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013969",
            "telephone_number": "540-662-4572",
            "fax_number": "540-722-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHLAK",
        "first_name": "PAUL",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002206",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103301023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.