Individual provider Active NPI

Kristen Lynn Engle, M.D.

  • Surgery Physician
  • Pittsburgh, PA
National Provider Identifier
1366417305
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
63613 Issued in WI
Practice address
205 Carnegie PL
Pittsburgh, PA 15208-2705
Phone
(412) 694-3271
Fax
(878) 302-0303
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 63613 WI Primary
Surgery Physician 208600000X G76696 CA

Addresses

Primary practice location

205 Carnegie PL
Pittsburgh, PA 15208-2705

Mailing address

205 Carnegie PL
Pittsburgh, PA 15208-2705
Phone (412) 694-3271

Other identifiers 1

IdentifierTypeStateIssuer
00G766960MedicaidCA

Other names 1

  • Dr. Kristen Engle Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WI, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20120601000248 PA Practitioner - General Surgery 1557524543 Reassigns benefits to 1 organization
I20150514001730 WI Practitioner - General Surgery 1557524543 Reassigns benefits to 1 organization
I20170103001692 CA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 1557524543 Practice locations: Bakersfield, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76696CAMDSocial Worker
G76696CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medicine Inc CurrentSince Apr 14, 2020 Accepting new patients
Baycare Clinic LLP CurrentSince May 26, 2015 Accepting new patients
Upmc Community Medcine Inc CurrentSince Apr 14, 2020 Accepting new patients
Upmc Community Medicine, Inc Current Accepting new patients
Baycare Clinic LLP CurrentSince May 26, 2015 Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

5140 Liberty Ave
Pittsburgh, PA 15224
Phone (412) 682-2100

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

2845 Greenbrier Rd
Ste 220
Green Bay, WI 54311
Phone (920) 288-8230

1035 Kepler Dr
Green Bay, WI 54311

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1366417305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 CARNEGIE PL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152082705",
            "telephone_number": "412-694-3271",
            "fax_number": "878-302-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CARNEGIE PL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152082705",
            "telephone_number": "412-694-3271",
            "fax_number": "878-302-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLE",
        "first_name": "KRISTEN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "63613",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G76696",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G766960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "SMITH",
            "middle_name": "ENGLE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.