Kathleen Jesiolowski, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

TP006006B Issued in PA

Practice address

120 S Tan Aly Ste 1
Fredericksburg, PA 17026-9349

Phone

(717) 865-6644

Fax

(717) 865-5666

NPI assigned

Aug 23, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjesiolowski@lima.medentdirect.com

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.

• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427
  Medicare reassignment NPD
• Pinnacle Health Medical Services

  • Gastroenterology Physician
  • Mechanicsburg, PA
  • NPI 1295552073
  NPD
• Pinnacle Health Medical Services

  • Neurological Surgery Physician
  • Harrisburg, PA
  • NPI 1487836763
  NPD

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1487647756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CUMBERLAND ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425233",
            "telephone_number": "717-273-6741",
            "fax_number": "717-273-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S TAN ALY STE 1",
            "city": "FREDERICKSBURG",
            "state": "PA",
            "postal_code": "170269349",
            "telephone_number": "717-865-6644",
            "fax_number": "717-865-5666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Cumberland St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170425233",
            "country_code": "US",
            "telephone_number": "717-273-6741 x332",
            "fax_number": "717-273-6337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JESIOLOWSKI",
        "first_name": "KATHLEEN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "TP006006B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50000765",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjesiolowski115315@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "120 S Tan Aly Ste 1",
            "city": "Fredericksburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170269349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fredericksburg Dental Center, LLC
• Fredericksburg Family Eyecare, P.C.
• Patricia Golembiewski, C.R.N.P.
• Monika H Groff, OD
• Robert J Harding, PA
• Angela Michelle Joseph, COTA
• Sarah Mancuso Joseph, LCSW
• Michelle Renee Krall, M.S. OTR/L
• Tracy Walker Kurtz, MSPT
• Shelby Lee Margut, MD

• Family Nurse Practitioner in Fredericksburg, PA
• Providers in Fredericksburg, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.