Carrie Lynn Kowalski, MPAP, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22329 Issued in CA

Practice address

604 Rose Avenue
Venice, CA 90291

Phone

(310) 392-8636

NPI assigned

Jun 2, 2012

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Venice Family ClinicGroup PAC ID 2264339126, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ckowalski753513@direct.ochin.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Venice, CA
  • NPI 1669418513
  Medicare reassignment Care Compare group NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Culver City, CA
  • NPI 1003842360
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Venice, CA
  • NPI 1124054564
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Hawthorne, CA
  • NPI 1518739515
  NPD
• Venice Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Santa Monica, CA
  • NPI 1558397067
  NPD

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

{
    "created_epoch": "1338595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1497016877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 ROSE AVENUE",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "90291",
            "telephone_number": "310-392-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 ROSE AVENUE",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "90291",
            "telephone_number": "310-392-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MPAP, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-02",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carrie.kowalski.p1@direct.venicefamilyclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "604 Rose Avenue",
            "city": "Venice",
            "state": "CA",
            "country_code": "US",
            "postal_code": "90291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shir Rachel Klainman, MSW
• Sarah Ann Klein
• Bernice Tan Ko
• Rachel Kory, RD
• Arthur James Koster
• Kevin Kunkel, MFT
• Sakura Kuo
• Karen C. Lamp, M.D.
• Katharine Hardy Lansaw
• Alison Bryn Lasov, LMFT

• Physician Assistant in Venice, CA
• Providers in Venice, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.
• 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.