NPIMap

Individual provider Active NPI

Stephan Kowalyk, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Greensburg, PA
National Provider Identifier
1457458168
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD052412L Issued in PA
Practice address
540 South St
Suite 306
Greensburg, PA 15601-2774
Phone
(724) 832-3130
Fax
(724) 832-7301
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD052412L PA Primary

Addresses

Primary practice location

540 South St
Suite 306
Greensburg, PA 15601-2774

Mailing address

540 South St
Suite 306
Greensburg, PA 15601-2774
Phone (724) 832-3130

Other identifiers 1

IdentifierTypeStateIssuer
0014688720001MedicaidPA

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
I20100617000222 PA Practitioner - Endocrinology 7810984572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Rutgers New Jersey Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

508 S Church St
Mount Pleasant, PA 15666-1702
Phone (724) 832-3130

660 Pellis Rd
Suite 202
Greensburg, PA 15601-4633
Phone (724) 832-3130

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
20.32 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
67.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endocrinology Specialists, PC Endocrinology, Diabetes & Metabolism CurrentSince Jun 15, 1994 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

530 South St
Ste 220
Greensburg, PA 15601
Phone (724) 832-3130

540 South St
Ste 306
Greensburg, PA 15601
Phone (724) 832-3130

660 Pellis Rd
Ste 202
Greensburg, PA 15601
Phone (724) 244-3999

Organizations & group practices 2

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1457458168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 SOUTH ST",
            "address_2": "SUITE 306",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012774",
            "telephone_number": "724-832-3130",
            "fax_number": "724-832-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 SOUTH ST",
            "address_2": "SUITE 306",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012774",
            "telephone_number": "724-832-3130",
            "fax_number": "724-832-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALYK",
        "first_name": "STEPHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "PA",
            "license": "MD052412L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014688720001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.