Individual provider Active NPI

Sydney Marie Kacik, APRN FNP-BC

  • Family Nurse Practitioner
  • Morgantown, WV
National Provider Identifier
1336830397
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
103523 Issued in WV
Practice address
1075 Van Voorhis Rd
Morgantown, WV 26505-3586
Phone
(304) 598-6216
Fax
(304) 598-2602
NPI assigned
May 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 103523 WV Primary

Addresses

Primary practice location

1075 Van Voorhis Rd
Morgantown, WV 26505-3586

Mailing address

1075 Van Voorhis Rd
Morgantown, WV 26505-3586
Phone (304) 598-6216

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231222003213 WV Practitioner - Nurse Practitioner 2062862527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 293-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Aug 26, 2023 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 26, 2023 Accepting new patients

Locations

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

1075 Van Voorhis Rd
Morgantown, WV 26505
Phone (304) 598-0122

1075 Van Voorhis Rd
Ste 150
Morgantown, WV 26505
Phone (304) 598-0122

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1336830397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 VAN VOORHIS RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053586",
            "telephone_number": "304-598-6216",
            "fax_number": "304-598-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 VAN VOORHIS RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053586",
            "telephone_number": "304-598-6216",
            "fax_number": "304-598-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACIK",
        "first_name": "SYDNEY",
        "middle_name": "MARIE",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "103523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.