Individual provider Active NPI

Carol E. Kowtoniuk, D.O.

  • Family Medicine Physician
  • Johnstown, PA
National Provider Identifier
1144369869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS004976L Issued in PA
Practice address
226 Fairfield Ave
Johnstown, PA 15906-2310
Phone
(814) 535-6167
Fax
(814) 535-5428
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS004976L PA Primary

Addresses

Primary practice location

226 Fairfield Ave
Johnstown, PA 15906-2310

Mailing address

226 Fairfield Ave
Johnstown, PA 15906-2310
Phone (814) 535-6167

Other identifiers 1

IdentifierTypeStateIssuer
OS004976LMedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110602000666 PA Practitioner - Family Practice 6103002910

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS004976LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144369869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 FAIRFIELD AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159062310",
            "telephone_number": "814-535-6167",
            "fax_number": "814-535-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 FAIRFIELD AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159062310",
            "telephone_number": "814-535-6167",
            "fax_number": "814-535-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWTONIUK",
        "first_name": "CAROL",
        "middle_name": "E.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS004976L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OS004976L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.