Individual provider Active NPI

Susan R Kowall, PA

  • Physician Assistant
  • Washington, PA
National Provider Identifier
1164528568
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA050955 Issued in PA
Practice address
95 Leonard Ave
Building #1 Suite 300
Washington, PA 15301-3368
Phone
(724) 225-3640
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00939 WV
Physician Assistant 363A00000X MA050955 PA Primary

Addresses

Primary practice location

95 Leonard Ave
Building #1 Suite 300
Washington, PA 15301-3368

Mailing address

125 Markwood Dr
Canonsburg, PA 15317-8531
Phone (412) 855-9576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070813000415 WV Practitioner - Physician Assistant 4486745940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

1 Medical Park
Wheeling, WV 26003-6379

Hospital & facility affiliations

  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
939WVMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Inc CurrentSince Apr 12, 2016 Accepting new patients
Valley Radiologists Inc Past Accepting new patients
Wheeling Hospital Inc Past Accepting new patients
Wheeling Hospital, Inc. Past Accepting new patients
Washington Physician Services Physician Assistant Past Accepting new patients

Locations

2000 Eoff St
Wheeling, WV 26003
Phone (304) 234-0123

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

Organizations & group practices 5

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 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1164528568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MARKWOOD DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153178531",
            "telephone_number": "412-855-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 LEONARD AVE",
            "address_2": "BUILDING #1 SUITE 300",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153013368",
            "telephone_number": "724-225-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALL",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "00939",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA050955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, PA

Sources for this page

Verify at the official NPI Registry.