Active NPI
Tracey Kwiat, PAC
- Physician Assistant
- Beavercreek, OH
National Provider Identifier
1427074087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50001904
- Practice address
- 1868 Wilene Dr
Beavercreek, OH 45432-4022 - Phone
- (937) 208-2088
- Fax
- (937) 208-2898
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50001904 | OH | Primary |
Addresses
Primary practice location
1868 Wilene Dr
Beavercreek, OH 45432-4022
Mailing address
1868 Wilene Dr
Beavercreek, OH 45432-4022
Phone (937) 208-2088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50001904 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio Neurosurgical Institute Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Neurological Surgery Physician
- Dayton, OH
- NPI 1700819547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427074087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1868 WILENE DR",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454324022",
"telephone_number": "937-208-2088",
"fax_number": "937-208-2898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1868 WILENE DR",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454324022",
"telephone_number": "937-208-2088",
"fax_number": "937-208-2898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWIAT",
"first_name": "TRACEY",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50001904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.