Kevin Malicky, CRNP F-NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F0214324 Issued in PA

Practice address

1225 Warm Springs Ave
Huntingdon, PA 16652-2350

Phone

(818) 643-8485

Fax

(814) 643-8755

NPI assigned

Feb 14, 2014

Last updated

Mar 2, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tripoint Health Group PCGroup PAC ID 6709367584, 3 clinicians

NumedxGroup PAC ID 1355747395, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Punxsutawney Home Health Care Home health agency, Punxsutawney, PA, CCN 397096
• Punxsutawney Area Hospital Hospital, Punxsutawney, PA, CCN 390199

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Numedx

  • General Practice Physician
  • Punxsutawney, PA
  • NPI 1790360303
  Medicare reassignment Care Compare group NPD
• Tripoint Health Group PC

  • Physical Medicine & Rehabilitation Physician
  • Punxsutawney, PA
  • NPI 1649136532
  Medicare reassignment Care Compare group NPD
• Caremed PA PC

  • Family Nurse Practitioner
  • Middletown, PA
  • NPI 1891540431
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Punxsutawney Area Hospital Inc

  • General Acute Care Hospital
  • Punxsutawney, PA
  • NPI 1265449870
  Care Compare affiliation
• Punxsutawney Area Hospital Inc

  dba Punxsutawney Home Health Care

  • Home Health Agency
  • Punxsutawney, PA
  • NPI 1437259611
  Care Compare affiliation

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1447674114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 FREDERICK RD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166027475",
            "telephone_number": "814-937-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WARM SPRINGS AVE",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522350",
            "telephone_number": "818-643-8485",
            "fax_number": "814-643-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICKY",
        "first_name": "KEVIN",
        "credential": "CRNP F-NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-14",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "F0214324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "349540G0F",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102948711",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonea Mahboob, MD
• Lindsey Anne Mainello, CRNP
• Mainstream Counseling
• Mainstreamcounseling
• David Ryan Maletta, COTA/L
• Louann Ruth Mansberger-Darby, M.S., L.P.C., L.P.N.
• James Warren Mansberger, DO
• Tyler Dwane Mansberger, PA-C
• Kaitlyn Marhefka
• Sarah Elizabeth Martz, DPT

• Nurse Practitioner in Huntingdon, PA
• Providers in Huntingdon, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.