Kiski Valley Community Medicine, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0S008135L Issued in PA

Legal business name

KISKI VALLEY COMMUNITY MEDICINE, PC

Practice address

310 S 2ND St
Apollo, PA 15613-1150

Phone

(724) 478-2999

Fax

(724) 478-3005

NPI assigned

Jun 28, 2005

Last updated

Apr 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel J Kupas, DONPI 1477742005

Title

Owner/Physician

Phone

(724) 478-2999

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Tax ID family

Kiski Valley Comm Medicine PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kiski Valley Community Medicine

  • Non-Pharmacy Dispensing Site
  • Apollo, PA
  • NPI 1417274473
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel J Kupas, D.O.

  • Family Medicine Physician
  • Apollo, PA
  • NPI 1477742005
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1497751002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 SOUTH SECOND STREET",
            "city": "APOLLO",
            "state": "PA",
            "postal_code": "156131111",
            "telephone_number": "724-478-2999",
            "fax_number": "724-478-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S 2ND ST",
            "city": "APOLLO",
            "state": "PA",
            "postal_code": "156131150",
            "telephone_number": "724-478-2999",
            "fax_number": "724-478-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISKI VALLEY COMMUNITY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "KUPAS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "724-478-2999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "0S008135L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015371560003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "257824",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Hainan, CRNP
• Kimberly C Ingram-Morlacci, D.C.
• Innovative Wellness Solutions LLC
• Ashley Johnson, PT
• Kiski Valley Community Medicine
• Ryan Klingensmith, NCC, LPC
• Daniel J Kupas, D.O.
• Daniel Andrew Mangus Jr., L.AC, CP
• Ruth D Martin-Pisarcik, MD
• Emily Nicole Miknis, LSW

• Family Medicine Physician in Apollo, PA
• Providers in Apollo, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.