Individual provider Active NPI

Kayla Malackowski, PA-C

  • Physician Assistant
  • Altoona, PA
National Provider Identifier
1336800044
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1701 12TH Ave Ste a
Altoona, PA 16601-3100
Phone
(814) 944-5062
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1701 12TH Ave Ste a
Altoona, PA 16601-3100

Mailing address

1800 E Park Ave
State College, PA 16803-6797
Phone (814) 278-4818

Other practice location 1

1800 E Park Ave
State College, PA 16803-6701
Phone (814) 278-4818

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
I20220217000481 PA Practitioner - Physician Assistant 4486047339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Nittany Medical Center Health Services IncGroup PAC ID 8426136797, 366 clinicians

Practice addresses (Care Compare)

129 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-3626

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

143 Hospital Dr
State College, PA 16803-5500
Phone (814) 237-3470

155 Wellness Way
State College, PA 16803-6702

155 Wellness Way
State College, PA 16803-6797
Phone (814) 231-7000

Hospital & facility affiliations

  • Mount Nittany Medical Center Hospital, State College, PA, CCN 390268

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center Health Services Inc CurrentSince Oct 16, 2023 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

Organizations & group practices 3

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 5

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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1336800044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036797",
            "telephone_number": "814-278-4818",
            "fax_number": "814-234-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 12TH AVE STE A",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166013100",
            "telephone_number": "814-944-5062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 E Park Ave",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168036701",
            "country_code": "US",
            "telephone_number": "814-278-4818",
            "fax_number": "814-234-6150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALACKOWSKI",
        "first_name": "KAYLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.