Individual provider Active NPI

Kacie Marie Kidd, MD

  • Student in an Organized Health Care Education/Training Program
  • Pittsburgh, PA
National Provider Identifier
1255743035
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3420 Fifth Avenue
Oakland Medical Building
Pittsburgh, PA 15213
Phone
(412) 692-6677
NPI assigned
May 28, 2014
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

3420 Fifth Avenue
Oakland Medical Building
Pittsburgh, PA 15213

Mailing address

3600 Forbes Avenue
Forbes Tower-Plaza Level Suite 140
Pittsburgh, PA 12513
Phone (304) 293-1224

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkidd144652@direct.wvuhsdirect.com Health Information Exchange (HIE)

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210715000826 WV Practitioner - Pediatric Medicine 2163725771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
West Virginia University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6040 University Town Centre Dr
Morgantown, WV 26501-2421
Phone (304) 285-7222

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jun 2, 2021 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jun 2, 2021 Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

6040 University Town Centre Dr
Morgantown, WV 26501

Interoperability endpoints

  • Direct secure messaging: kkidd144652@direct.wvuhsdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1255743035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVENUE",
            "address_2": "FORBES TOWER-PLAZA LEVEL SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "12513",
            "telephone_number": "304-293-1224",
            "fax_number": "304-293-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 FIFTH AVENUE",
            "address_2": "OAKLAND MEDICAL BUILDING",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213",
            "telephone_number": "412-692-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "KACIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkidd144652@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Medical Center Dr",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265061200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.