Kristina Fodor, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0005425 Issued in CO

Practice address

2709 N Tejon St
Colorado SPGS, CO 80907-6231

Phone

(719) 473-0872

NPI assigned

Nov 19, 2018

Reactivated

Aug 28, 2020

Last updated

Sep 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kristina Mischler Former name

Medicare fee-for-service enrollment

Enrolled in NJ, CO2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Asthma and Allergy Associates, PCGroup PAC ID 2466341177, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmischler18056@epicdirect.rwjbh.org

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.

• Asthma & Allergy Associates, PC

  • Allergy & Immunology (Internal Medicine) Physician
  • Colorado Springs, CO
  • NPI 1043204829
  Medicare reassignment Care Compare group NPD
• Rutgers Health-RWJ Neurosurgery Faculty

  • Urology Physician
  • New Brunswick, NJ
  • NPI 1710012604
  Medicare reassignment
• Asthma & Allergy Associates, PC

  • Allergy & Immunology (Internal Medicine) Physician
  • Colorado Springs, CO
  • NPI 1528665239
  NPD
• Rutgers Health-RWJ Neurosurgery Faculty

  • Surgery Physician
  • Somerville, NJ
  • NPI 1548356926
  NPD
• Rutgers Health-RWJ Neurosurgery Faculty

  • Durable Medical Equipment & Medical Supplies
  • Neptune, NJ
  • NPI 1861290744
  NPD

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1104395193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 N TEJON ST",
            "city": "COLORADO SPGS",
            "state": "CO",
            "postal_code": "809076231",
            "telephone_number": "719-473-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 N TEJON ST",
            "city": "COLORADO SPGS",
            "state": "CO",
            "postal_code": "809076231",
            "telephone_number": "719-473-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FODOR",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "deactivation_date": "2020-08-17",
        "reactivation_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "MISCHLER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Anthony Gauthier, MS, LPCC, ADDC

• Physician Assistant in Colorado SPGS, CO
• Providers in Colorado SPGS, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.