Ronald Matthew Kmiecik, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1854 Issued in NE

Practice address

2560 N Healthy Way
Fremont, NE 68025-2315

Phone

(402) 941-5073

Fax

(402) 727-7628

NPI assigned

Dec 22, 2011

Sex

Male

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 NE, TX2 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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Surgical Specialists of Conroe, PLLCGroup PAC ID 3577880210, 4 clinicians

Emergency Medicine Services of TX, PLLCGroup PAC ID 3375909351, 374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Houston Healthcare Conroe Hospital, Conroe, TX, CCN 450222

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ronald.kmiecik@hca9.eclinicaldirectplus.com
• Direct secure messaging: rkmiecik233859@achce.catholichealth.net

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.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment Care Compare group NPD
• Surgical Specialists of Conroe, PLLC

  • Orthopaedic Surgery Physician
  • Conroe, TX
  • NPI 1689062135
  Medicare reassignment Care Compare group
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment NPD

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

• Chca Conroe LP

  dba Conroe Regional Medical Center

  • General Acute Care Hospital
  • Conroe, TX
  • NPI 1962455816
  Care Compare affiliation

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1609145564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 N HEALTHY WAY",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252315",
            "telephone_number": "402-727-1091",
            "fax_number": "402-727-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 N HEALTHY WAY",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252315",
            "telephone_number": "402-941-5073",
            "fax_number": "402-727-7628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2725 S 144th St Ste 212",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681445253",
            "country_code": "US",
            "telephone_number": "402-637-0800",
            "fax_number": "402-637-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KMIECIK",
        "first_name": "RONALD",
        "middle_name": "MATTHEW",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "onclinic@orthonebraska.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2725 S 144th St Ste 212",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681445253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Larry G Kisby, PA-C
• Shauna Klein
• Kami Klingforth
• Eastyn Klink
• Katie Klitz
• Corey Knierim
• Raven Knight, LIMHP
• Luann R Knobbe
• Joey Knoell
• Rodney K Koerber, M.D.

• Physician Assistant in Fremont, NE
• Providers in Fremont, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.