Individual provider Active NPI

Kelly M Laskowski, CRNP

  • Nurse Practitioner
  • Erie, PA
National Provider Identifier
1265804546
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015452 Issued in PA
Practice address
100 Peach St Ste 200
Erie, PA 16507-1423
Phone
(814) 877-7733
Fax
(814) 456-7213
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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 SP015452 PA Primary

Addresses

Primary practice location

100 Peach St Ste 200
Erie, PA 16507-1423

Mailing address

100 Peach St Ste 200
Erie, PA 16507-1423
Phone (814) 877-7733

Other names 1

  • Kelly M Martin Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelly.m.martin@upmcdirect.com

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
I20151118002353 PA Practitioner - Nurse Practitioner 3072528751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Practice addresses (Care Compare)

5241 Buffalo Rd
Erie, PA 16510-2391
Phone (814) 877-7686

Hospital & facility affiliations

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP015452PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Epn Hamot Urgent Care LLC CurrentSince Apr 30, 2017 Accepting new patients
Regional Health Services Inc CurrentSince May 16, 2016 Accepting new patients

Locations

7200 Peach St
Unit 16
Erie, PA 16509
Phone (814) 860-3301

100 Peach St
Ste 200
Erie, PA 16507
Phone (814) 456-7733

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

5241 Buffalo Rd
Erie, PA 16510
Phone (814) 877-5100

2 Hot Metal St
Bldg 3RD
Pittsburgh, PA 15203

Interoperability endpoints

  • Direct secure messaging: kelly.m.martin@upmcdirect.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.

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1265804546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PEACH ST STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071423",
            "telephone_number": "814-877-7733",
            "fax_number": "814-456-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PEACH ST STE 200",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071423",
            "telephone_number": "814-877-7733",
            "fax_number": "814-456-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASKOWSKI",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.m.martin@upmcdirect.com",
            "affiliation": "N",
            "address_1": "100 Peach St Ste 200",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165071423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MARTIN",
            "middle_name": "M",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.