Andrew Christopher Konopacki, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00407700 Issued in NJ

Practice address

456 Prospect Ave
West Orange, NJ 07052-4112

Phone

(973) 731-6767

Fax

(973) 731-9881

NPI assigned

Sep 29, 2016

Last updated

Sep 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Essential Diagnostics, P.a.

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1376245753
  Medicare reassignment NPD
• Immediate Care Medical Walk-in of Hazlet, PA

  • Urgent Care Clinic/Center
  • Hazlet, NJ
  • NPI 1245595313
  Medicare reassignment
• Prohealth Urgent Care Medicine of New Jersey LLP

  • Emergency Care Clinic/Center
  • Edgewater, NJ
  • NPI 1477927754
  Medicare reassignment
• Urgent Care Physicians of New Jersey, LLC

  • Emergency Medicine Physician
  • Red Bank, NJ
  • NPI 1447622402
  Medicare reassignment

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1285183350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 W SAINT GEORGES AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070365638",
            "telephone_number": "908-925-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 PROSPECT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524112",
            "telephone_number": "973-731-6767",
            "fax_number": "973-731-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOPACKI",
        "first_name": "ANDREW",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00407700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Illya Kohlberg, C.P.N.P
• Vijay Kumar Kolluri, MD
• Naga Malleswari Komati, MD
• Kimberly Susan Kones, OTR
• Yekyung Kong
• Rebecca H Konstandt, PT
• Kiely Konyak, DPT
• Rebecca Korabelnikov
• Joseph M Koziol, MD FACS
• Michael Joseph Kraft

• Physician Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.