Individual provider Active NPI

Kristina Michelle Shock, PA-C

  • Physician Assistant
  • Pittsburgh, PA
National Provider Identifier
1649605197
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA056234 Issued in PA
Practice address
4003 Penn Ave
Pittsburgh, PA 15224-1337
Phone
(724) 309-5095
Fax
(724) 765-5475
NPI assigned
Sep 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 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 MA056234 PA Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MA056234 PA

Addresses

Primary practice location

4003 Penn Ave
Pittsburgh, PA 15224-1337

Mailing address

4003 Penn Ave
Pittsburgh, PA 15224-1337
Phone (724) 309-5095

Other names 1

  • Ms. Kristina Michelle Hanna Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140220000826 PA Practitioner - Physician Assistant 1052541984 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CH Specialty Services PA PCGroup PAC ID 2567827157, 75 clinicians
Curana Health of Pennsylvania PCGroup PAC ID 6507246345, 98 clinicians

Practice addresses (Care Compare)

526 N Saint Cloud St
Suite 1601
Allentown, PA 18104-5041
Phone (337) 991-9276

6351 W Lake Rd
Erie, PA 16505-2676
Phone (337) 991-9276

815 S Main St
Washington, PA 15301-6255
Phone (337) 991-9276

835 S Main St
Washington, PA 15301-6267
Phone (337) 991-9276

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA056234PAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Aug 11, 2013 Accepting new patients
University of Pittsburgh Physicians CurrentSince Aug 11, 2013 Accepting new patients
Washington Physician Services Physician Assistant CurrentSince Jan 1, 2020 Accepting new patients
Upmc Community Medicine Inc Past Accepting new patients

Locations

200 Lothrop St
Ste 200
Pittsburgh, PA 15213
Phone (412) 647-3260

815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000

200 Lothrop St
Ste 9055
Pittsburgh, PA 15213
Phone (412) 647-4620

190 N Main St
Ste 204
Washington, PA 15301
Phone (724) 223-9335

Interoperability endpoints

  • Direct secure messaging: kristina.shock@398008301912068.direct.elationemr.com

Organizations & group practices 7

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.

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1649605197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4003 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241337",
            "telephone_number": "724-309-5095",
            "fax_number": "724-765-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 PENN AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241337",
            "telephone_number": "724-309-5095",
            "fax_number": "724-765-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCK",
        "first_name": "KRISTINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-03",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056234",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MA056234",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "HANNA",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.