NPIMap

Individual provider Active NPI

Krystle M Wood, PA

  • Medical Physician Assistant
  • Lehighton, PA
National Provider Identifier
1174861116
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA055903 Issued in PA
Practice address
211 N 12TH St
Lehighton, PA 18235-1138
Phone
(610) 377-7174
Fax
(610) 377-4785
NPI assigned
Jan 25, 2013
Last updated
Jul 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA055903 PA Primary

Addresses

Primary practice location

211 N 12TH St
Lehighton, PA 18235-1138

Mailing address

211 N 12TH St
Lehighton, PA 18235-1138
Phone (610) 377-7174

Other identifiers 1

IdentifierTypeStateIssuer
MA055903OtherPAMEDICAL LICENCE

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
I20130605000789 PA Practitioner - Physician Assistant 9638317464 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4301 5TH St Hwy
Temple, PA 19560-1739
Phone (610) 208-8801

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.05 of 100Reported as group
Quality
80.49
Promoting interoperability
91
Improvement activities
40
Cost
82.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA055903PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Physician Services of Maryland, PC CurrentSince May 1, 2019 Accepting new patients
St Joseph Regional Health Network CurrentSince May 1, 2019 Accepting new patients
St. Joseph Regional Health Network CurrentSince May 1, 2019 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Oct 28, 2013 Accepting new patients
St Luke's Physician Group Inc CurrentSince Oct 28, 2013 Accepting new patients
Lehigh Gorge Inpatient Services, PLLC Past Accepting new patients
Regents of the University of California - Ucsd Medical Group Past Accepting new patients
Humboldt Emergency Physicians LLC Past Accepting new patients
St Joseph Regional Health Network Past Accepting new patients

Locations

6649 Chrisphalt Dr
Ste 101
Bath, PA 18014
Phone (610) 537-6614

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

108 Plaza Dr
Ste 101
Blandon, PA 19510
Phone (610) 208-4650

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

211 N 12th St
Lehighton, PA 18235
Phone (610) 377-1300

44 W 21st St
#101
Northampton, PA 18067
Phone (610) 261-0999

135 Lafayette Ave
Palmerton, PA 18071
Phone (610) 826-1103

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

145 N 6th St
Fl 2
Reading, PA 19601
Phone (610) 208-4558

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

4301 5th Street Hwy
Ste 102
Temple, PA 19560

Interoperability endpoints

  • Direct secure messaging: krystle.wood@slpg.direct-sluhn.org

Organizations & group practices 12

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.

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": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1174861116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N 12TH ST",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182351138",
            "telephone_number": "610-377-7174",
            "fax_number": "610-377-4785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N 12TH ST",
            "city": "LEHIGHTON",
            "state": "PA",
            "postal_code": "182351138",
            "telephone_number": "610-377-7174",
            "fax_number": "610-377-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KRYSTLE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE",
            "identifier": "MA055903",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehighton, PA

Sources for this page

Verify at the official NPI Registry.