Individual provider Active NPI

Marcie Krivak, PA

  • Physician Assistant
  • Weirton, WV
National Provider Identifier
1609016724
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1300 Issued in WV
Practice address
651 Colliers Way Ste 510
Weirton, WV 26062-5054
Phone
(304) 797-6595
Fax
(304) 797-6052
NPI assigned
Mar 2, 2009
Last updated
Mar 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50 002226 OH
Physician Assistant 363A00000X 1300 WV Primary

Addresses

Primary practice location

651 Colliers Way Ste 510
Weirton, WV 26062-5054

Mailing address

109 Mount Wood Rd
Wheeling, WV 26003-2632
Phone (304) 233-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20130226000405 WV Practitioner - Physician Assistant 1951581289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WMC Physician Practices LLCGroup PAC ID 0244466753, 112 clinicians

Practice addresses (Care Compare)

485 Colliers Way
Weirton, WV 26062-5012

651 Colliers Way
Weirton, WV 26062-5053
Phone (304) 797-6557

651 Colliers Way
Weirton, WV 26062-5055

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
57.47
Improvement activities
40
Cost
70.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1300WVMDDermatology Physician
50 002226OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
WMC Physician Practices LLC CurrentSince Jun 1, 2025 Accepting new patients

Locations

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

651 Colliers Way
Ste 207
Weirton, WV 26062
Phone (304) 797-6433

651 Colliers Way
Ste 510
Weirton, WV 26062
Phone (304) 723-6740

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1609016724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MOUNT WOOD RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260032632",
            "telephone_number": "304-233-2455",
            "fax_number": "304-233-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 COLLIERS WAY STE 510",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625054",
            "telephone_number": "304-797-6595",
            "fax_number": "304-797-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIVAK",
        "first_name": "MARCIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-02",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50 002226",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "1300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weirton, WV

Sources for this page

Verify at the official NPI Registry.