NPIMap

Individual provider Active NPI

Jay J Kiessling, MD

  • Vascular Surgery Physician
  • Erie, PA
National Provider Identifier
1386731248
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD040102L Issued in PA
Practice address
5401 Peach St Ste 3600
Erie, PA 16509-2601
Phone
(814) 868-2170
Fax
(814) 868-2108
NPI assigned
Oct 10, 2006
Last updated
Apr 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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 MD040102L PA
Vascular Surgery Physician 2086S0129X MD040102L PA Primary

Addresses

Primary practice location

5401 Peach St Ste 3600
Erie, PA 16509-2601

Mailing address

1 Lecom PL
Erie, PA 16505-2571

Other identifiers 1

IdentifierTypeStateIssuer
1026721580002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120130000265 PA Practitioner - Vascular Surgery 1355243791 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millcreek Community HospitalGroup PAC ID 8426020173, shared by 24 NPIs, 67 clinicians

Practice addresses (Care Compare)

5401 Peach St
Suite 3600
Erie, PA 16509-2601
Phone (814) 868-2170

5515 Peach St
Erie, PA 16509-2603
Phone (814) 864-4031

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue99
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millcreek Community Hospital Current Accepting new patients
Medical Associates of Erie CurrentSince Sep 1, 2014 Accepting new patients
Medical Associates of Erie Surgery CurrentSince Sep 1, 2014 Accepting new patients
Millcreek Community Hospital Current Accepting new patients
Millcreek Community Hospital CurrentSince Jun 15, 2020 Accepting new patients
Millcreek Community Hospital CurrentSince Nov 2, 2022 Accepting new patients
Medical Associates of Erie Surgery Current Accepting new patients
Millcreek Community Hospital Surgery CurrentSince Jun 15, 2020 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1 Lecom Pl
Erie, PA 16505

2000 W Grandview Blvd
Erie, PA 16509
Phone (814) 868-1001

2625 Parade St
Erie, PA 16504
Phone (814) 452-6383

5401 Peach St
Erie, PA 16509
Phone (814) 868-2170

5401 Peach St
Ste 3300
Erie, PA 16509
Phone (814) 868-7840

5401 Peach St
Ste 3600
Erie, PA 16509
Phone (814) 868-2170

5515 Peach St
Erie, PA 16509
Phone (814) 864-4031

Interoperability endpoints

  • Direct secure messaging: jkeissling@maoeim-pa.direct.office.nextgen.com

Organizations & group practices 9

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.

Hospital & facility affiliations 10

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1386731248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LECOM PL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052571",
            "fax_number": "814-868-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 PEACH ST STE 3600",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092601",
            "telephone_number": "814-868-2170",
            "fax_number": "814-868-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESSLING",
        "first_name": "JAY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD040102L",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD040102L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026721580002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.