Kacper Kisala, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

6665 Issued in CT

Practice address

148 Hazard Ave
Enfield, CT 06082-4520

Phone

(860) 763-7650

NPI assigned

Jul 11, 2024

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

Medicare fee-for-service enrollment

Enrolled in MA, CT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians

Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkisala3761170@direct.trinity-health.org

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.

• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment Care Compare group
• Riverbend Medical Group, Inc.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1841651197
  Medicare reassignment Care Compare group
• Riverbend Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1265023154
  NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• Mwa,PC

  • Internal Medicine Physician
  • Chicopee, MA
  • NPI 1609821990
  NPD (past)

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

• The Mercy Hospital Inc

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1043204316
  Care Compare affiliation
• The Mercy Hospital Inc

  • Rehabilitation Hospital Unit
  • Springfield, MA
  • NPI 1750360798
  Care Compare affiliation

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1518704030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SAM WEST RD",
            "city": "SOUTHWICK",
            "state": "MA",
            "postal_code": "010779734",
            "telephone_number": "413-250-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824520",
            "telephone_number": "860-763-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISALA",
        "first_name": "KACPER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "6665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Allen Kimmel, MD
• Paul Kindall, LMFT
• Adrianne M King
• Falinda King
• Amy Kingsbury
• Felecia A Knight
• Brian David Knox, MS, CCC-A
• Christine Knuchel
• Erin Kober, M.A.,CCC-SLP
• Kristin Ladd Kolack, OTR/L

• Surgical Physician Assistant in Enfield, CT
• Providers in Enfield, CT by specialty
• Surgical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.