Active NPI
Logan Z Krikava, PA-C
- Surgical Physician Assistant
- Middletown, NY
National Provider Identifier
1568939775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 022936
- Practice address
- 95 Crystal Run Rd
Middletown, NY 10941-7001 - Phone
- (845) 703-6999
- Fax
- (845) 703-6297
- NPI assigned
- Oct 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 022936 | NY | Primary |
Addresses
Primary practice location
95 Crystal Run Rd
Middletown, NY 10941-7001
Mailing address
155 Crystal Run Rd
Middletown, NY 10941-4057
Phone (845) 703-6999
Other names 1
- Logan Z Reisenbigler
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | logan.reisenbiglerpa.p1@direct.crystalrun.nextgenshare.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20 Grand St
FL 3
Warwick, NY 10990-1035
Phone (845) 987-3906
257 Lafayette Ave
Suffern, NY 10901-4830
Phone 845353560025027
Hospital & facility affiliations
- Good Samaritan Hospital of Suffern
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022936 | NY | MD | Occupational Therapist |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Warwick, NY
- NPI 1487694345
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Suffern, NY
- NPI 1346213469
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1568939775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 CRYSTAL RUN RD",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109414057",
"telephone_number": "845-703-6999",
"fax_number": "845-703-6297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 CRYSTAL RUN RD",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109417001",
"telephone_number": "845-703-6999",
"fax_number": "845-703-6297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRIKAVA",
"first_name": "LOGAN",
"middle_name": "Z",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-25",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NY",
"license": "022936",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "logan.reisenbiglerpa.p1@direct.crystalrun.nextgenshare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "95 Crystal Run Rd",
"city": "Middletown",
"state": "NY",
"country_code": "US",
"postal_code": "109417001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LOGAN",
"last_name": "REISENBIGLER",
"middle_name": "Z",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Middletown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.