Individual provider Active NPI

Kristy Ann Sawicki, PA-C, ATC

  • Physician Assistant
  • Hackensack, NJ
National Provider Identifier
1407963549
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
360 Essex St
Suite 303
Hackensack, NJ 07601-8550
Phone
(551) 996-8867
Fax
(551) 996-8873
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0126-000995 VA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

360 Essex St
Suite 303
Hackensack, NJ 07601-8550

Mailing address

360 Essex St
Suite 303
Hackensack, NJ 07601-8550
Phone (551) 996-8867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20110518000375 NJ Practitioner - Physician Assistant 4688850191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

20 Prospect Ave
Hackensack, NJ 07601-1997

20 Prospect Ave
Hackensack, NJ 07601-1999

30 Prospect Ave
Hackensack, NJ 07601-1915

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0126-000995VAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 1, 2012 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

360 Essex St
Ste 303
Hackensack, NJ 07601
Phone (551) 996-3091

20 Prospect Ave
Ste 600
Hackensack, NJ 07601
Phone (201) 488-1036

Interoperability endpoints

  • Direct secure messaging: kristy.sawicki@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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 2

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1407963549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST",
            "address_2": "SUITE 303",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018550",
            "telephone_number": "551-996-8867",
            "fax_number": "551-996-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST",
            "address_2": "SUITE 303",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018550",
            "telephone_number": "551-996-8867",
            "fax_number": "551-996-8873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWICKI",
        "first_name": "KRISTY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126-000995",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.