NPIMap

Individual provider Active NPI

Mary Katherine Kushnerick, PA-C

  • Physician Assistant
  • Wyomissing, PA
National Provider Identifier
1124807912
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2760 Century Blvd
Wyomissing, PA 19610-3359
Phone
(610) 347-8496
NPI assigned
Sep 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2760 Century Blvd
Wyomissing, PA 19610-3359

Mailing address

2760 Century Blvd
Wyomissing, PA 19610-3359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626004568 PA Practitioner - Physician Assistant 3072057413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Arthritis and Osteoporosis Center, Inc.Group PAC ID 0345223293, 7 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2760 Century Blvd
Suite 3
Wyomissing, PA 19610-3359
Phone (610) 375-4251

Hospital & facility affiliations

  • Reading Hospital Hospital, West Reading, PA, CCN 390044
  • Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096
  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Infusion Center of Berks County PC PastSince Jul 24, 2022 Accepting new patients
King'S College PastSince Sep 1, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mary.katherine.kushnerick.1@3215.direct.athenahealth.com

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 10

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": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1124807912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 CENTURY BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 CENTURY BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103359",
            "telephone_number": "610-347-8496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHNERICK",
        "first_name": "MARY KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.