Individual provider Active NPI

Kara Breznak, PA

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1366561318
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA058017 Issued in PA
Practice address
160 E Erie Ave
Philadelphia, PA 19134-1011
Phone
(215) 427-3750
NPI assigned
Mar 29, 2007
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2008 SC
Physician Assistant 363A00000X MA058017 PA Primary
Surgical Physician Assistant 363AS0400X 010699 NY

Addresses

Primary practice location

160 E Erie Ave
Philadelphia, PA 19134-1011

Mailing address

PO Box 825366
Philadelphia, PA 19182-1011
Phone (484) 628-5820

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
I20241122001681 PA Practitioner - Physician Assistant 8729217716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
STC Pediatrics LLCGroup PAC ID 7315372323, 73 clinicians

Practice addresses (Care Compare)

160 E Erie Ave
Philadelphia, PA 19134-1011

300 E Hunting Park Ave
St Christophers Ped Assoc Child Protection
Philadelphia, PA 19124-6018
Phone (215) 427-8363

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008SCMDUrology Physician
010699NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC CurrentSince Jan 1, 2025 Accepting new patients
STC Pediatrics LLC CurrentSince Jan 1, 2025 Accepting new patients
STC Pediatrics LLC Past Accepting new patients

Locations

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1366561318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825366",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191821011",
            "telephone_number": "484-628-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREZNAK",
        "first_name": "KARA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2008",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058017",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "010699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.