Individual provider Active NPI

Kimberly A Konieczki, CRNP

  • Nurse Practitioner
  • Erie, PA
National Provider Identifier
1205831740
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
VP005114B Issued in PA
Practice address
120 E 2ND St
Third Floor
Erie, PA 16507-1537
Phone
(814) 877-8000
Fax
(814) 452-2210
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X VP005114B PA Primary

Addresses

Primary practice location

120 E 2ND St
Third Floor
Erie, PA 16507-1537

Mailing address

120 E 2ND St
Third Floor
Erie, PA 16507-1537
Phone (814) 877-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kimberly.konieczki@upmcdirect.com UPMC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070219000714 PA Practitioner - Nurse Practitioner 8426150665 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

3406 Peach St
Erie, PA 16508-2740
Phone (814) 877-5381

Hospital & facility affiliations

  • Meadville Medical Center Hospital, Meadville, PA, CCN 390113
  • Lecom Health Corry Memorial Hospital Hospital, Corry, PA, CCN 391308

Merit-based Incentive Payment System (MIPS)

Final score
81.89 of 100Reported as group
Quality
65.8
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
VP005114BPAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Services Inc CurrentSince Jan 1, 2021 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jun 9, 2013 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jun 9, 2013 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

3406 Peach St
Erie, PA 16508
Phone (814) 877-5381

120 E 2nd St
Fl 3
Erie, PA 16507
Phone (814) 877-4600

3471 5th Ave
Ste 810
Pittsburgh, PA 15213
Phone (412) 692-4607

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

Interoperability endpoints

  • Direct secure messaging: kkonieczki141832@upmc.direct-ci.com

Organizations & group practices 4

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 2

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1205831740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-877-8000",
            "fax_number": "814-452-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071537",
            "telephone_number": "814-877-8000",
            "fax_number": "814-452-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIECZKI",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP005114B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.konieczki@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.