Andrew Mark Kiselica, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2020008417 Issued in MO

Practice address

701 S 5TH St
Clark Hall RM 501
Columbia, MO 65211-0001

Phone

(573) 882-1561

Fax

(573) 884-1889

NPI assigned

Jul 16, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

80.23 of 100Reported as group

Quality

58.17

Promoting interoperability

100

Improvement activities

40

Cost

75.92

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1104434190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S 5TH ST",
            "address_2": "CLARK HALL RM 501",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652110001",
            "telephone_number": "573-882-1561",
            "fax_number": "573-884-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISELICA",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2022-10-05",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "2020008417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "DIRECT",
            "address_1": "1 Hospital Dr",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652120001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benjamin Jay Kirby, MD
• Jean Kirch-Holliday, LPC
• Sarah Rachael Kirchoff
• Benjamin Kirk, MD
• Anna L Kirkley, LPC
• Kobe Jarrett Kisling
• George L Kistler, M.D.
• Janice Elaine Kite
• David M Klachko, M.D.
• Abigail Darlene Klatt, PT, DPT

• Clinical Neuropsychologist in Columbia, MO
• Providers in Columbia, MO by specialty
• Clinical Neuropsychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.