NPIMap

Individual provider Active NPI

Michael D. Kacsmar, CRNP

  • Family Nurse Practitioner
  • Du Bois, PA
National Provider Identifier
1427282706
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP010286 Issued in PA
Practice address
529 Sunflower Dr
Du Bois, PA 15801-2378
Phone
(814) 371-1510
Fax
(814) 371-2922
NPI assigned
May 14, 2009
Last updated
Jul 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP010286 PA Primary

Addresses

Primary practice location

529 Sunflower Dr
Du Bois, PA 15801-2378

Mailing address

300 E Main St
PO Box 189
Reynoldsville, PA 15851-1282
Phone (814) 371-1510

Other identifiers 1

IdentifierTypeStateIssuer
1026380200001MedicaidPA

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
I20090706000091 PA Practitioner - Nurse Practitioner 3971654880 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Punxsutawney Area Hospital IncGroup PAC ID 3375517147, 33 clinicians

Practice addresses (Care Compare)

81 Hillcrest Dr
Punxsutawney, PA 15767-2605
Phone (814) 938-7066

81 Hillcrest Dr
Punxsutawney, PA 15767-2616

841 Hospital Rd
Suite 2300
Indiana, PA 15701-3699
Phone (888) 452-4762

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Punxsutawney Area Hospital Inc CurrentSince Oct 9, 2012 Accepting new patients
Du Bois Nephrology Associates, PC CurrentSince Apr 12, 2017 Accepting new patients
Punxsutawney Area Hospital Inc Family CurrentSince Oct 9, 2012 Accepting new patients
Indiana Healthcare Physician Services Inc CurrentSince Jan 8, 2021 Accepting new patients
Indiana Healthcare Physician Services, Inc Family CurrentSince Jan 8, 2021 Accepting new patients
Punxsutawney Area Hosp Em Med Fpa Past Accepting new patients
Dubois Regional Medical Center PastSince Jun 3, 2013 Accepting new patients
DRMG Opthalmology Past Accepting new patients
Dubois Regional Medical Group PC Past Accepting new patients

Locations

190 W Park Ave
Ste 1
Dubois, PA 15801
Phone (814) 371-7590

640 Kolter Dr
Indiana, PA 15701
Phone (724) 357-7196

841 Hospital Rd
Ste 2300
Indiana, PA 15701
Phone (724) 349-7820

879 Hospital Rd
Indiana, PA 15701
Phone (724) 349-3031

3 Penn Ctr W
Ste 127
Pittsburgh, PA 15276

720 W Mahoning St
Ste 300
Punxsutawney, PA 15767
Phone (724) 357-8087

81 Hillcrest Dr
Punxsutawney, PA 15767
Phone (814) 938-1800

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 5

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": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1427282706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MAIN ST",
            "address_2": "PO BOX 189",
            "city": "REYNOLDSVILLE",
            "state": "PA",
            "postal_code": "158511282",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 SUNFLOWER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012378",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACSMAR",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-14",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP010286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026380200001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.